The Tooth Repair Shoppe, LTD.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

060008257 Issued in IL

Legal business name

THE TOOTH REPAIR SHOPPE, LTD.

Practice address

610 W Roosevelt Rd
Suite A1
Wheaton, IL 60187-5087

Phone

(630) 682-0844

Fax

(630) 682-1428

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gregory C. Calleia, DDSNPI 1134144371

Title

Dentist

Phone

(630) 682-0844

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Gregory Charles Calleia, DDS

  • General Practice Dentistry
  • Wheaton, IL
  • NPI 1134144371
  NPD (past) Authorized official

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1669529145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W. ROOSEVELT ROAD",
            "address_2": "SUITE A1",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "60187",
            "telephone_number": "630-682-0844",
            "fax_number": "630-682-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W ROOSEVELT RD",
            "address_2": "SUITE A1",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875087",
            "telephone_number": "630-682-0844",
            "fax_number": "630-682-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TOOTH REPAIR SHOPPE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "CALLEIA",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "630-682-0844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "060008257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teryn'S Therapy & Wellness, PLLC
• Sampada Thatte
• The Everpresent Center, P.C.
• The Hearing Doctors Inc
• The Mentor Coach Foundation
• Sarah Marie Therriault
• Adam Thieret, MA CF SLP
• Ryan Christopher Thill, LPC
• Anna Eileen Thoma
• Anthony James Thomas

• General Practice Dentistry in Wheaton, IL
• Providers in Wheaton, 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 Jun 20, 2008; 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.