VL Dental Care Two

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

VL DENTAL CARE TWO

Doing business as

Route 14 Dentistry

Practice address

6315 Northwest Hwy
Suite a
Crystal Lake, IL 60014-7939

Phone

(815) 455-3368

Fax

(815) 455-3306

NPI assigned

Feb 20, 2017

Last updated

Feb 20, 2017By 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

Mr. James Becker

Title

Office Manager

Phone

(847) 358-9700

Specialties & licenses 1

Addresses

Other names 1

• Route 14 Dentistry Doing business as

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1760921019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 NORTHWEST HWY",
            "address_2": "SUITE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147939",
            "telephone_number": "815-455-3368",
            "fax_number": "815-455-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 NORTHWEST HWY",
            "address_2": "SUITE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147939",
            "telephone_number": "815-455-3368",
            "fax_number": "815-455-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VL DENTAL CARE TWO",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-358-9700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Route 14 Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.