Barry E Booth, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Practice address

12635 W 143Rd St
Homer Glen, IL 60491-8381

Phone

(708) 301-0005

Fax

(708) 301-0063

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770629065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12635 W 143RD ST",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918381",
            "telephone_number": "708-301-0005",
            "fax_number": "708-301-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12635 W 143RD ST",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918381",
            "telephone_number": "708-301-0005",
            "fax_number": "708-301-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "BARRY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janna Boger, RN
• Mary Kathryn Bombard, MA, NCC, LCPC
• Laura Booker
• Booth Orthodontics LLC
• Booth Orthodontics of Homer Glen LLP
• Evan Booth, DDS
• Ryan Elston Booth, DDS
• Nicole Eileen Boswell, MA, LPC, NCC
• Tyler Branson, PHARM.D.
• Brenczewski Physical Therapy

• Orthodontics and Dentofacial Orthopedics Dentistry in Homer Glen, IL
• Providers in Homer Glen, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.