NPIMap

Organization Active NPI

Lisle Family Dental Inc

  • Dentist
  • Lisle, IL
National Provider Identifier
1710373550
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027922 Issued in IL
Legal business name
LISLE FAMILY DENTAL INC
Practice address
3033 Ogden Ave
Suite 114
Lisle, IL 60532-1673
Phone
(630) 961-1030
Fax
(630) 961-0223
NPI assigned
Apr 8, 2015
Last updated
Apr 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Authorized official

Name
Dr. Fariha Siddiqui, DDSNPI 1982839585
Title
Partner
Phone
(773) 880-6054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019027922 IL Primary

Addresses

Primary practice location

3033 Ogden Ave
Suite 114
Lisle, IL 60532-1673

Mailing address

3033 Ogden Ave
Suite 114
Lisle, IL 60532-1673
Phone (630) 961-1030

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1710373550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 OGDEN AVE",
            "address_2": "SUITE 114",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321673",
            "telephone_number": "630-961-1030",
            "fax_number": "630-961-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 OGDEN AVE",
            "address_2": "SUITE 114",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321673",
            "telephone_number": "630-961-1030",
            "fax_number": "630-961-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISLE FAMILY DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-08",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "FARIHA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "773-880-6054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.