NPIMap

Organization Active NPI

Procare Dental Group, P.C.

Doing business as Village Square Dentistry

  • Dentist
  • Lake Zurich, IL
National Provider Identifier
1811054059
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PROCARE DENTAL GROUP, P.C.
Doing business as
Village Square Dentistry
Practice address
715 Ela Rd
Ste 1a
Lake Zurich, IL 60047-6300
Phone
(847) 726-7908
Fax
(847) 726-7839
NPI assigned
Jan 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert G. Brunetti, D.D.S.NPI 1033341615
Title
C.E.O.
Phone
(847) 640-1112

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
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X IL Primary

Addresses

Primary practice location

715 Ela Rd
Ste 1a
Lake Zurich, IL 60047-6300

Mailing address

605 E Algonquin Rd
Ste 300
Arlington Heights, IL 60005-4373
Phone (847) 640-1112

Other names 1

  • Village Square Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Procare Dental Group PC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

715 Ela Rd
Ste 1A
Lake Zurich, IL 60047
Phone (847) 726-2908

Practitioners & affiliated clinicians

Practitioners 3

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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811054059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E ALGONQUIN RD",
            "address_2": "STE 300",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054373",
            "telephone_number": "847-640-1112",
            "fax_number": "847-640-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 ELA RD",
            "address_2": "STE 1A",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600476300",
            "telephone_number": "847-726-7908",
            "fax_number": "847-726-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUNETTI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "847-640-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Square Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Zurich, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.