Sam Mudrik DDS LTD

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019.026125 Issued in IL

Legal business name

SAM MUDRIK DDS LTD

Practice address

317 W Dundee Rd
Buffalo Grove, IL 60089-3545

Phone

(847) 520-3020

Fax

(847) 520-7564

NPI assigned

Mar 17, 2017

Last updated

Mar 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teresa Sanchez

Title

Front Desk Coordinator

Phone

(847) 520-3020

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, and the practitioner matching its NPPES authorized official.

• Sam Mudrik, DDS

  • General Practice Dentistry
  • Buffalo Grove, IL
  • NPI 1033237813
  NPD (past)

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1679014062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W DUNDEE RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600893545",
            "telephone_number": "847-520-3020",
            "fax_number": "847-520-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W DUNDEE RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600893545",
            "telephone_number": "847-520-3020",
            "fax_number": "847-520-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM MUDRIK DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "FRONT DESK COORDINATOR",
        "authorized_official_telephone_number": "847-520-3020"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019.026125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Sadkhin, ACUPUNCTURIST
• Natalya Sagalov
• Meeta Saha, O.D.
• Kristina Marie Sakas Katz, DDS, MS
• Anastasia Rose Sakkos, PA
• Sanders Court Pediatrics, LTD.
• Sandstone Care Illinois, LLC
• Amy Sapienza, M.S., CCC-SLP
• Parimal G Sapovadia, D.M.D.
• Jacalyn Saracco

• Dental Clinic/Center in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.