NPIMap

Organization Active NPI

The Center for Periodontics & Implant Dentistry

  • Periodontics
  • Buffalo Grove, IL
National Provider Identifier
1861762650
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
060005106 Issued in IL
Legal business name
THE CENTER FOR PERIODONTICS & IMPLANT DENTISTRY
Practice address
1501 W Dundee Rd
#108
Buffalo Grove, IL 60089-4006
Phone
(847) 818-9950
Fax
(847) 818-9968
NPI assigned
Jan 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Kristen Frank
Title
Office Manager
Phone
(847) 818-9950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 060005106 IL Primary

Addresses

Primary practice location

1501 W Dundee Rd
#108
Buffalo Grove, IL 60089-4006

Mailing address

1501 W Dundee Rd
#108
Buffalo Grove, IL 60089-4006

Other names 1

  • CPID Other name

National Provider Directory

National Provider Directory

Locations

1501 W Dundee Rd
Ste 108
Buffalo Grove, IL 60089
Phone (847) 818-9950

Practitioners & affiliated clinicians

Practitioners 2

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": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1861762650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W DUNDEE RD",
            "address_2": "#108",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W DUNDEE RD",
            "address_2": "#108",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894006",
            "telephone_number": "847-818-9950",
            "fax_number": "847-818-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR PERIODONTICS & IMPLANT DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "FRANK",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-818-9950"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "060005106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CPID",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.