NPIMap

Organization Active NPI

Orthodontic Experts LTD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mundelein, IL
National Provider Identifier
1821564196
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHODONTIC EXPERTS LTD
Practice address
1529 S Lake St
Mundelein, IL 60060-4210
Phone
(847) 749-4340
NPI assigned
Oct 15, 2018
Organization subpart
Yes
Parent organization
ORTHODONTIC EXPERTS LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Monika Bzdal
Title
Manager
Phone
(773) 801-7171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1529 S Lake St
Mundelein, IL 60060-4210

Mailing address

1250 W Northwest Hwy
Mount Prospect, IL 60056-2274
Phone (773) 801-7171

Other identifiers 1

IdentifierTypeStateIssuer
019028280MedicaidIL

Other names 1

  • Orthodontic Experts, Ltd Other name

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Experts23 organizations share this tax ID, including this one
Part of
Orthodontic Experts

Other organizations with this tax ID 22

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

View all 22

Locations

1529 S Lake St
Mundelein, IL 60060

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1821564196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W NORTHWEST HWY",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562274",
            "telephone_number": "773-801-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 S LAKE ST",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604210",
            "telephone_number": "847-749-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC EXPERTS LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHODONTIC EXPERTS LTD",
        "enumeration_date": "2018-10-15",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "BZDAL",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-801-7171"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019028280",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthodontic Experts, Ltd",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mundelein, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.