Organization Active NPI

DRS. Mellovitz & Grumet Dental Associates, L.L.C.

  • General Practice Dentistry
  • Highland Park, IL
National Provider Identifier
1669149449
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DRS. MELLOVITZ & GRUMET DENTAL ASSOCIATES, L.L.C.
Practice address
1893 Sheridan Rd Ste 318
Highland Park, IL 60035-2646
Phone
(847) 433-9350
NPI assigned
Aug 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Authorized official

Name
Mrs. Jennifer Lynn Costantini
Title
Office Manager
Phone
(847) 433-9350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1893 Sheridan Rd Ste 318
Highland Park, IL 60035-2646

Mailing address

1893 Sheridan Rd Ste 318
Highland Park, IL 60035-2646
Phone (847) 433-9350

National Provider Directory

National Provider Directory

Locations

1893 Sheridan Rd
Ste 318
Highland Park, IL 60035
Phone (847) 433-9350

Practitioners & affiliated clinicians

Practitioners 1

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": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1669149449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 SHERIDAN RD STE 318",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352646",
            "telephone_number": "847-433-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 SHERIDAN RD STE 318",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352646",
            "telephone_number": "847-433-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. MELLOVITZ & GRUMET DENTAL ASSOCIATES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "COSTANTINI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-433-9350",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.