Plainfield Family Dental Center

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

Last updated

Feb 20, 2012By the provider in NPPES

Organization subpart

No

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.NPI 1154542090

Title

Owner

Phone

(815) 436-1000

Specialties & licenses 1

Addresses

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.

• Pullara Family Dental Center

  dba Plainfield Family Dental Center

  • General Practice Dentistry
  • Coal City, IL
  • NPI 1821201575
  NPD tax ID

Locations

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.

• Peter J Pullara Jr., D.D.S.

  • Dentist
  • Morris, IL
  • NPI 1154542090
  Authorized official Same address or phone

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": []
}

• Plainfield Counseling Center, LLC
• Plainfield Dental Care P.C.
• Plainfield Dental Practice Inc
• Plainfield Dental, LTD.
• Plainfield Family Clinic, LLC
• Plainfield Fire Protection District
• Plainfield Ophthalmology, M.D., S.C.
• Plainfield Ophthalmology, M.D., S.C.
• Plainfield Pediatric Dental Care PC
• Plainfield School Dist 202

• General Practice Dentistry in Plainfield, IL
• Providers in Plainfield, IL by specialty
• General Practice Dentistry in Illinois

• 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.