Timothy V Erdle DMD PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

TIMOTHY V ERDLE DMD PLLC

Practice address

310 Tri State Pkwy Ste 100
Gurnee, IL 60031-5282

Phone

(847) 662-3414

NPI assigned

Mar 10, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Vincent Erdle, DMDNPI 1962816603

Title

Owner

Phone

(847) 662-3414

Specialties & licenses 1

Addresses

Other names 1

• Institute of Dental Implants and Periodontics Doing business as

Locations

Practitioners 2

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

• Timothy V Erdle, D.M.D.

  • Periodontics
  • Gurnee, IL
  • NPI 1962816603
  NPD Authorized official
• Peter S Domagala, DDS

  • Periodontics
  • Durango, CO
  • NPI 1356415673
  NPD (past)

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1700587342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 TRI STATE PKWY STE 100",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315282",
            "telephone_number": "847-662-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 TRI STATE PKWY STE 100",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315282",
            "telephone_number": "847-662-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY V ERDLE DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "ERDLE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-662-3414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Institute of Dental Implants and Periodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Institute of Dental Implants and Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tien C. Cheng, MD,SC
• Michael Timins, MD
• Irina Timoshevskaya, PA-C
• Timothy Casey DPM PC
• Timothy L. Straka D.D.S., L.L.C.
• Claudia Tiwet, MD
• Neda Zergollern Tkalcevic, MD
• Matthew J Tobkin, DDS
• Together in Wellness PLLC
• Akilra Tolbert, L.M.T.

• Multi-Specialty Clinic/Center in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.