Booth Orthodontics LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

BOOTH ORTHODONTICS LLC

Practice address

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

Phone

(708) 301-0005

NPI assigned

Jan 17, 2019

Last updated

Jan 17, 2019By 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

Dr. Ryan E Booth, DDS, MSDNPI 1578036638

Title

Owner/Orthodontist

Phone

(708) 301-0005

Specialties & licenses 1

Addresses

Locations

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.

• Ryan Elston Booth, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Homer Glen, IL
  • NPI 1578036638
  Authorized official Same address or phone

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1821562323",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTH ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/ORTHODONTIST",
        "authorized_official_telephone_number": "708-301-0005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Big Wishes Therapy Services
• Kennedy Claire Blackwell
• Janna Boger, RN
• Mary Kathryn Bombard, MA, NCC, LCPC
• Laura Booker
• Booth Orthodontics of Homer Glen LLP
• Barry E Booth, D.D.S., M.S.
• Evan Booth, DDS
• Ryan Elston Booth, DDS
• Nicole Eileen Boswell, MA, LPC, NCC

• 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 Jan 17, 2019; 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.