Lake Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LAKE FAMILY DENTAL

Practice address

1372 Patriot Blvd
Glenview, IL 60026-7777

Phone

(847) 998-9660

Fax

(847) 998-9661

NPI assigned

Aug 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter Sung Jong Chang, D.D.S.

Title

Co-Owner

Phone

(847) 998-9660

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryung Suh, D.D.S.

  • Dentist
  • Glenview, IL
  • NPI 1437250495
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639188295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1372 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600267777",
            "telephone_number": "847-998-9660",
            "fax_number": "847-998-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600267777",
            "telephone_number": "847-998-9660",
            "fax_number": "847-998-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "SUNG JONG",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "847-998-9660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Laczak
• Eduardo Julian Ladlad, M.D.
• Natalie Laduke, PHD
• Jaime Lagunas, COTA
• Charre Leanette Laing
• Lake North Institute LLC
• Lake Shore Gastroenterology
• Aliya Ferozali Lakhani, APN-CNP
• Kathryn Kelly Lalonde, ATC
• Kathryn Mary Lamermayer Flaherty, L.C.S.W.

• General Practice Dentistry in Glenview, IL
• Providers in Glenview, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.