Dental Club St. Charles P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL CLUB ST. CHARLES P.C.

Practice address

3381 W Main St Ste 3
St Charles, IL 60175-1008

Phone

(630) 513-2121

NPI assigned

Jul 20, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Thomas J Ryan Jr., DDSNPI 1245327519

Title

President

Phone

(708) 305-0729

Specialties & licenses 1

Addresses

Other names 1

• Dental Club St. Charles Doing business as

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Joseph Ryan Jr., D.D.S.

  • General Practice Dentistry
  • Tinley Park, IL
  • NPI 1245327519
  NPD Authorized official
• Pinky Arora, D.D.S.

  • Dentist
  • Saint Charles, IL
  • NPI 1578780557
  NPD (past)
• Richard Alan Disimoni, D.D.S.

  • Dentist
  • Saint Charles, IL
  • NPI 1750498234
  NPD (past)

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1720713993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11310 POPLAR CREEK LN",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604677308",
            "telephone_number": "708-305-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3381 W MAIN ST STE 3",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601751008",
            "telephone_number": "630-513-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CLUB ST. CHARLES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-305-0729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Club St. Charles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joan Demers Bittner, RBT
• Pamela Marie Denhof, ATC
• Dennis a. Long, M.D., S.C.
• Katherine Janet Denny
• Dental Club Hoffman Estates P.C.
• Cheryl D Denz, LCPC
• Teila Desarno, L.C.P.C., C.A.D.C.
• Suzanne N. Deserto, L.M.F.T., C.A.D.C.
• Luke James Dettlo
• Melissa Nicole Di Natale, LPC

• Dental Clinic/Center in St Charles, IL
• Providers in St Charles, 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 Jul 20, 2022; 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.