Active NPI
Christianna Potter, DDS
- General Practice Dentistry
- Algonquin, IL
National Provider Identifier
1821724014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.033904
- Practice address
- 1462 S Randall Rd
Algonquin, IL 60102-5919 - Phone
- (847) 346-1621
- NPI assigned
- Jul 28, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.033904 | IL | Primary |
Addresses
Primary practice location
1462 S Randall Rd
Algonquin, IL 60102-5919
Mailing address
PO Box 7773
Monroe, LA 71211-7773
Phone (318) 791-2290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.033904 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658966400000",
"number": "1821724014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7773",
"city": "MONROE",
"state": "LA",
"postal_code": "712117773",
"telephone_number": "318-791-2290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1462 S RANDALL RD",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601025919",
"telephone_number": "847-346-1621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "CHRISTIANNA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-28",
"last_updated": "2022-07-28",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.033904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Algonquin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.