NPIMap

Organization Active NPI

Northshore Dental Partners, PLLC

  • Dental Clinic/Center
  • Evanston, IL
National Provider Identifier
1861271702
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
NORTHSHORE DENTAL PARTNERS, PLLC
Practice address
2200 Central St
Evanston, IL 60201-1416
Phone
(847) 869-7710
NPI assigned
Sep 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Coleen-Shannon Licar
Title
Manager
Phone
(847) 864-8151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2200 Central St
Evanston, IL 60201-1416

Mailing address

2200 Central St
Evanston, IL 60201-1416
Phone (847) 869-7710

National Provider Directory

National Provider Directory

Locations

2200 Central St
Evanston, IL 60201
Phone (847) 869-7710

Practitioners & affiliated clinicians

Practitioners 3

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": "1695859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1861271702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 CENTRAL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011416",
            "telephone_number": "847-869-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CENTRAL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011416",
            "telephone_number": "847-869-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE DENTAL PARTNERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "LICAR",
        "authorized_official_first_name": "COLEEN-SHANNON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-864-8151"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.