NPIMap

Organization Active NPI

North Creek Dental PC

  • General Practice Dentistry
  • Tinley Park, IL
National Provider Identifier
1700800356
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019023655 Issued in IL
Legal business name
NORTH CREEK DENTAL PC
Practice address
18425 W West Creek Dr
Suite I
Tinley Park, IL 60477-6767
Phone
(708) 532-4131
Fax
(708) 532-4151
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Mr. Thomas Joseph Ryan Jr., DDSNPI 1245327519
Title
Owne Northecreekdentalcare
Phone
(708) 532-4131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019023655 IL Primary

Addresses

Primary practice location

18425 W West Creek Dr
Suite I
Tinley Park, IL 60477-6767

Mailing address

18425 W West Creek Dr
Suite I
Tinley Park, IL 60477-6767
Phone (708) 532-4131

National Provider Directory

National Provider Directory

Locations

18425 West Creek Dr
Ste I
Tinley Park, IL 60477
Phone (708) 305-0729

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1700800356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18425 W WEST CREEK DR",
            "address_2": "SUITE I",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776767",
            "telephone_number": "708-532-4131",
            "fax_number": "708-532-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 W WEST CREEK DR",
            "address_2": "SUITE I",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776767",
            "telephone_number": "708-532-4131",
            "fax_number": "708-532-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CREEK DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNE NORTHECREEKDENTALCARE",
        "authorized_official_telephone_number": "708-532-4131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019023655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.