Pediatric and Family Dent

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

019027333 Issued in IL

Legal business name

PEDIATRIC AND FAMILY DENT

Practice address

38 Plymouth CT
Lincolnshire, IL 60069-3157

Phone

(312) 310-4543

NPI assigned

Jul 2, 2012

Organization subpart

No

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

Authorized official

Name

Scott Goldman

Title

President

Phone

(312) 310-4543

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1699039875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 PLYMOUTH CT",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693157",
            "telephone_number": "312-310-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 PLYMOUTH CT",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693157",
            "telephone_number": "312-310-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND FAMILY DENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-310-4543"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019027333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanne Lello Osei, NCC
• Kristin Ann Ostergaard, NP
• Alexandria Paradis
• Trisha Patel, DPT
• Peace of Serenity
• Beata Dorota Penar
• Joseph A Perkins Jr., DO
• Philip J Metres Jr, PH.D.,P.C.
• Cassandra Piekarski, PHARMD
• Hristo I Piponov, MD

• Pediatric Dentistry in Lincolnshire, IL
• Providers in Lincolnshire, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.