TLC Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-026934 Issued in IL

Legal business name

TLC DENTAL

Practice address

155 N Neltnor Blvd
West Chicago, IL 60185-2315

Phone

(630) 562-2500

NPI assigned

Mar 19, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Tricia A Letrero, DDS

Title

President

Phone

(708) 289-6042

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268956800000",
    "number": "1720302771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18612 W POINT DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774930",
            "telephone_number": "708-289-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N NELTNOR BLVD",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601852315",
            "telephone_number": "630-562-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A",
        "authorized_official_last_name": "LETRERO",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-289-6042",
        "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": "019-026934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.