Cedar Ridge Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CEDAR RIDGE DENTAL

Practice address

2110 W Algonquin Rd
Lake in the Hills, IL 60156-1370

Phone

(847) 854-0525

Fax

(847) 854-0525

NPI assigned

Mar 7, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Giovanni Aristodemo

Title

Doctor

Phone

(847) 854-0525

Specialties & licenses 1

Addresses

Other names 1

• Occlusal Enterprise Other name

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520380800000",
    "number": "1710489661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 W ALGONQUIN RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561370",
            "telephone_number": "847-854-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 W ALGONQUIN RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561370",
            "telephone_number": "847-854-0525",
            "fax_number": "847-854-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR RIDGE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-07",
        "status": "A",
        "authorized_official_last_name": "ARISTODEMO",
        "authorized_official_first_name": "GIOVANNI",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "847-854-0525",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Occlusal Enterprise",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth Carlson, SLP
• Carron and Hodack Dental Associates LLC (RidgePointe Dental)
• Richard L Carron, D.D.S.
• Jordaizn Castanos, FNP-BC
• Haydee Castelo
• Celebi Inc (Warrior Heart Therapy)
• Central States Imaging LLC (Rayus Radiology)
• Joel Luna Ceralde, FNP-C
• Maureen Chambers, LPC
• Chicago Hearing LLC (Miracle Ear)

• Dental Clinic/Center in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.