Main Dental Associates, LTD.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019-014182 Issued in IL

Legal business name

MAIN DENTAL ASSOCIATES, LTD.

Practice address

6457 Dempster St
Morton Grove, IL 60053-2604

Phone

(847) 966-1700

Fax

(847) 966-1785

NPI assigned

May 8, 2008

Last updated

May 8, 2008By 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

Dr. Richard A. Wilson, D.D.S.NPI 1932228061

Title

President

Phone

(847) 966-1700

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.

• Richard A Wilson, DDS

  • General Practice Dentistry
  • Morton Grove, IL
  • NPI 1932228061
  Authorized official Same address or phone

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1699942722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6457 DEMPSTER ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532604",
            "telephone_number": "847-966-1700",
            "fax_number": "847-966-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6457 DEMPSTER ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532604",
            "telephone_number": "847-966-1700",
            "fax_number": "847-966-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN DENTAL ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-966-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019-014182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sun Ae Ma, OD
• Moussa V Maatouk
• Mary Macgregor, D.O.
• Zemzem Mahmoud
• Ayham Mahmud
• Maine Township HS Dist 207
• Katie Makey
• Kristofer Malinowski, PT
• Juilio A Mancera, M.D.
• Annie Mannancheril

• Dental Clinic/Center in Morton Grove, IL
• Providers in Morton 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 May 8, 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.