Lisle Dental Specialists,Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

LISLE DENTAL SPECIALISTS,INC

Practice address

6070 State Route 53
Lisle, IL 60532-3395

Phone

(630) 426-7365

Fax

(630) 963-9344

NPI assigned

Jul 10, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Douglad Chang, DDS

Title

Owner

Phone

(630) 747-7778

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1801633664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 STATE ROUTE 53",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323395",
            "telephone_number": "630-426-7365",
            "fax_number": "630-963-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 STATE ROUTE 53",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323395",
            "telephone_number": "630-426-7365",
            "fax_number": "630-963-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISLE DENTAL SPECIALISTS,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "DOUGLAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-747-7778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENDODONTIST",
            "identifier": "1588977516",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERIODONTIST",
            "identifier": "1639958010",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda A Lis, M.D.
• Lisle C U School District 202
• Lisle Chiropractic Clinic, LLC
• Lisle Chiropratic LLC
• Lisle Dental Center P.C.
• Lisle Family Dental Inc
• Lisle-Woodridge Fire Protection District
• Jasmine Liu, DMD
• Laura Liu, DMD
• Tony W Liu, D.D.S.

• Periodontics in Lisle, IL
• Providers in Lisle, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.