Illinois Dental Providers, P. C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ILLINOIS DENTAL PROVIDERS, P. C.

Doing business as

DentalWorks of Plainfield

Practice address

12720 S Route 59
Suite 200
Plainfield, IL 60585-5505

Phone

(972) 755-0883

Fax

(216) 584-1750

NPI assigned

Oct 6, 2016

Last updated

Mar 20, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

DENTALONE PARTNERS, INCAs reported in NPPES

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

Authorized official

Name

Rachel Nittinger

Title

Manager Credentialing

Phone

(972) 755-0816

Specialties & licenses 1

Addresses

Other names 1

• DentalWorks of Plainfield Doing business as

Locations

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1659821312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 DALLAS PKWY STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 S ROUTE 59",
            "address_2": "SUITE 200",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855505",
            "telephone_number": "972-755-0883",
            "fax_number": "216-584-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DENTAL PROVIDERS, P. C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTALONE PARTNERS, INC",
        "enumeration_date": "2016-10-06",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "NITTINGER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "MANAGER CREDENTIALING",
        "authorized_official_telephone_number": "972-755-0816"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DentalWorks of Plainfield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DentalWorks of Plainfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Plainfield, IL
• Providers in Plainfield, 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 Mar 20, 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.