NPIMap

Organization Active NPI

Elmhurst Dental Group LTD

Doing business as West Dundee Dental Care

  • General Practice Dentistry
  • West Dundee, IL
National Provider Identifier
1811408453
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ELMHURST DENTAL GROUP LTD
Doing business as
West Dundee Dental Care
Practice address
602 W Main St
West Dundee, IL 60118-2026
Phone
(847) 426-5030
NPI assigned
Oct 23, 2017
Last updated
Oct 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Authorized official

Name
Mary Beth Walter
Title
Cfo
Phone
(630) 833-5110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

602 W Main St
West Dundee, IL 60118-2026

Mailing address

333 W 1St St
Elmhurst, IL 60126-2641
Phone (630) 833-5110

Other names 1

  • West Dundee Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elmhurst Dental Group7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

602 W Main St
West Dundee, IL 60118
Phone (847) 426-5030

Practitioners & affiliated clinicians

Practitioners 1

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": "1508716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1811408453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 1ST ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262641",
            "telephone_number": "630-833-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W MAIN ST",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182026",
            "telephone_number": "847-426-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMHURST DENTAL GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "630-833-5110"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Dundee Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Dundee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.