NPIMap

Organization Active NPI

Panacea Dental P.C.

  • General Practice Dentistry
  • Libertyville, IL
National Provider Identifier
1841903879
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PANACEA DENTAL P.C.
Practice address
755 S Milwaukee Ave Ste 230
Libertyville, IL 60048-3266
Phone
(847) 362-3250
NPI assigned
Jan 4, 2023
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Authorized official

Name
Sayali BhatwadekarNPI 1265751291
Title
President
Phone
(630) 965-7792

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

755 S Milwaukee Ave Ste 230
Libertyville, IL 60048-3266

Mailing address

1973 Easthaven Dr
Buffalo Grove, IL 60089-4810

National Provider Directory

National Provider Directory

Locations

755 S Milwaukee Ave
Ste 230
Libertyville, IL 60048
Phone (847) 362-3250

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": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1841903879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1973 EASTHAVEN DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE STE 230",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483266",
            "telephone_number": "847-362-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACEA DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "BHATWADEKAR",
        "authorized_official_first_name": "SAYALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-965-7792"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.