International Dental of Oak Lawn

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

INTERNATIONAL DENTAL OF OAK LAWN

Doing business as

International Dental of Oak Lawn

Practice address

9539 S Cicero Ave
Oak Lawn, IL 60453

Phone

(815) 730-1570

NPI assigned

Nov 3, 2017

Last updated

Jun 14, 2018By 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

Nadaunia Peacher

Title

Office Manager

Phone

(708) 634-3315

Specialties & licenses 1

Addresses

Other names 1

• International Dental of Oak Lawn Doing business as

Locations

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1679085245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9539 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533136",
            "telephone_number": "708-634-3315",
            "fax_number": "708-634-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9539 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "815-730-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL DENTAL OF OAK LAWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "PEACHER",
        "authorized_official_first_name": "NADAUNIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-634-3315"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "International Dental of Oak Lawn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Oak Lawn, IL
• Providers in Oak Lawn, 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 Jun 14, 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.