NPIMap

Organization Active NPI

Webster Dental Care Sauganash, LTD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1639658917
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WEBSTER DENTAL CARE SAUGANASH, LTD
Practice address
4801 W Peterson Ave Ste 316
Chicago, IL 60646-5726
Phone
(773) 685-9666
Fax
(773) 685-1967
NPI assigned
Aug 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Authorized official

Name
Manissa Lampman
Title
Regional Manager
Phone
(773) 685-9666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4801 W Peterson Ave Ste 316
Chicago, IL 60646-5726

Mailing address

4801 W Peterson Ave Ste 316
Chicago, IL 60646-5726
Phone (773) 685-9666

National Provider Directory

National Provider Directory

Locations

4801 W Peterson Ave
Ste 316
Chicago, IL 60646
Phone (773) 685-9666

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533686400000",
    "number": "1639658917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE STE 316",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465726",
            "telephone_number": "773-685-9666",
            "fax_number": "773-685-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE STE 316",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465726",
            "telephone_number": "773-685-9666",
            "fax_number": "773-685-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBSTER DENTAL CARE SAUGANASH, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A",
        "authorized_official_last_name": "LAMPMAN",
        "authorized_official_first_name": "MANISSA",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "773-685-9666"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.