Organization Active NPI

Plainfield Family Dental Center

  • General Practice Dentistry
  • Plainfield, IL
National Provider Identifier
1861607798
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019021493 Issued in IL
Legal business name
PLAINFIELD FAMILY DENTAL CENTER
Practice address
24204 W Lockport St
Plainfield, IL 60544-2902
Phone
(815) 436-1000
Fax
(815) 436-1464
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Authorized official

Name
Dr. Peter J. Pullara Jr., D.D.S.
Title
Owner
Phone
(815) 436-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019021493 IL Primary

Addresses

Primary practice location

24204 W Lockport St
Plainfield, IL 60544-2902

Mailing address

24204 W Lockport St
Plainfield, IL 60544-2902
Phone (815) 436-1000

National Provider Directory

National Provider Directory
Tax ID family
Plainfield Family Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

24204 W Lockport St
Plainfield, IL 60544
Phone (815) 436-1000

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1861607798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24204 W LOCKPORT ST",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605442902",
            "telephone_number": "815-436-1000",
            "fax_number": "815-436-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24204 W LOCKPORT ST",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605442902",
            "telephone_number": "815-436-1000",
            "fax_number": "815-436-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAINFIELD FAMILY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "PULLARA",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-436-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.