Mary Ann Baldino-Gomez D.D.S., S.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019020836 Issued in IL

Legal business name

MARY ANN BALDINO-GOMEZ D.D.S., S.C.

Practice address

2450 Grass Lake Rd
Suite C
Lindenhurst, IL 60046-5613

Phone

(847) 265-9022

Fax

(847) 265-9023

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mary Ann Baldino-Gomez, B.S., D.D.SNPI 1417309568

Title

Dentist

Phone

(847) 265-9022

Specialties & licenses 1

Addresses

Other names 1

• Mary Ann Baldino-Gomez D.D.S., S.C. Doing business as

Locations

Practitioners 1

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

• Mary Ann Baldino-Gomez, D.D.S.

  • Dentist
  • Lindenhurst, IL
  • NPI 1417309568
  NPD (past) Authorized official

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1861554834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18759 W. WESTWOOD PL",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600467432",
            "telephone_number": "847-265-2782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 GRASS LAKE RD",
            "address_2": "SUITE C",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600465613",
            "telephone_number": "847-265-9022",
            "fax_number": "847-265-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN BALDINO-GOMEZ D.D.S., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "BALDINO-GOMEZ",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-265-9022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "B.S., D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Ann Baldino-Gomez D.D.S., S.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Lutter
• Sandra Elizabeth Lutz, RN
• Peter John Macdonald, M.D.
• Emma Maki, ATC
• Sarah Mary Martinelli, CSFA
• Peyton Masterson
• Thomas Michael McGowan, M.D.
• Dave Thomas McKenna, M.A.
• Katherine Marie McNamara
• Midwest Neuro DX, S.C.

• All providers in Lindenhurst, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.