NPIMap

Organization Active NPI

NSP Dental LLC

  • Dental Clinic/Center
  • Libertyville, IL
National Provider Identifier
1740889344
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
NSP DENTAL LLC
Doing business as
NSP Dental LLC
Practice address
1900 Hollister Dr Ste 190
Libertyville, IL 60048-5283
Phone
(847) 680-0975
NPI assigned
Oct 23, 2020
Last updated
Oct 23, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
NSP DENTAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Authorized official

Name
Dr. Nicholas S Polito, DDSNPI 1114001302
Title
Dentist
Phone
(847) 367-1133

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
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

1900 Hollister Dr Ste 190
Libertyville, IL 60048-5283

Mailing address

998 Castlewood CT
Gurnee, IL 60031-4106

Other names 1

  • NSP Dental LLC Doing business as

National Provider Directory

National Provider Directory
Part of
NSP Dental LLC

Locations

1900 Hollister Dr
Ste 190
Libertyville, IL 60048
Phone (847) 680-0975

Practitioners & affiliated clinicians

Practitioners 4

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": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1740889344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 CASTLEWOOD CT",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 HOLLISTER DR STE 190",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485283",
            "telephone_number": "847-680-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NSP DENTAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NSP DENTAL LLC",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "POLITO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-367-1133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NSP Dental LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.