Mark E Klein DDS and Associates PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019017467 Issued in IL

Legal business name

MARK E KLEIN DDS AND ASSOCIATES PC

Doing business as

Village Dental

Practice address

958 Elk Grove Town Ctr
Elk Grove Village, IL 60007-3754

Phone

(847) 364-5100

Fax

(847) 364-9807

NPI assigned

Sep 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mark Edward Klein, DDS

Title

President

Phone

(847) 364-5100

Specialties & licenses 1

Addresses

Other names 1

• Village Dental Doing business as

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409702400000",
    "number": "1710387162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 ELK GROVE TOWN CTR",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073754",
            "telephone_number": "847-364-5100",
            "fax_number": "847-364-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 ELK GROVE TOWN CTR",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073754",
            "telephone_number": "847-364-5100",
            "fax_number": "847-364-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK E KLEIN DDS AND ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-03",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-364-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019017467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.