Platinum Dental Care

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

019026663 Issued in IL

Legal business name

PLATINUM DENTAL CARE

Practice address

333 Circle Avenue
Forest Park, IL 60130

Phone

(708) 771-0330

NPI assigned

Dec 2, 2010

Last updated

Dec 2, 2010By 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

Linda Nagl

Title

Office Manager

Phone

(708) 771-0330

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1710289327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CIRCLE AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601303624",
            "telephone_number": "708-771-0330",
            "fax_number": "708-771-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CIRCLE AVENUE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "60130",
            "telephone_number": "708-771-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "NAGL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-771-0330"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "IL",
            "license": "019026663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Perez
• Lisa J Peters, MD
• Connie J Pfiffner, LCSW
• Panom Phoungcherdchoo, M.D.
• Nicholas Pippin
• Elizabeth Jean Polachek
• Jeffrey L Pollack, LCSW
• Pop Pediatric Therapy Services, LLC
• Presence Behavioral Health (ProCare Centers)
• Tramaine Presley

• Health Maintenance Organization in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Health Maintenance Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.