Edc of Lemont PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

EDC OF LEMONT PLLC

Doing business as

Dentique - Lemont

Practice address

15543 E 127TH St Ste 103
Lemont, IL 60439-8584

Phone

(630) 243-8300

Fax

(630) 243-9493

NPI assigned

Sep 8, 2021

Last updated

Apr 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pradeep Khurana

Title

Owner

Phone

(312) 399-9595

Specialties & licenses 1

Addresses

Other names 1

• Dentique - Lemont Doing business as

Locations

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1740959345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15543 E 127TH ST STE 103",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604398584",
            "telephone_number": "630-243-8300",
            "fax_number": "630-243-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15543 E 127TH ST STE 103",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604398584",
            "telephone_number": "630-243-8300",
            "fax_number": "630-243-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDC OF LEMONT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-08",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "KHURANA",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-399-9595"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentique - Lemont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Lemont, IL
• Providers in Lemont, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.