NPIMap

Organization Active NPI

Elmhurst Dental Group, LTD Dba Bloomingdale Dental

  • General Practice Dentistry
  • Bloomingdale, IL
National Provider Identifier
1871826438
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ELMHURST DENTAL GROUP, LTD DBA BLOOMINGDALE DENTAL
Practice address
290 Springfield Dr
Suite 100
Bloomingdale, IL 60108-2214
Phone
(630) 529-0027
Fax
(630) 529-0068
NPI assigned
Sep 15, 2009
Organization subpart
Yes
Parent organization
ELMHURST DENTAL GROUP, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Authorized official

Name
Dr. Lawrence P Groh
Title
Owner
Phone
(630) 833-5110

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

290 Springfield Dr
Suite 100
Bloomingdale, IL 60108-2214

Mailing address

333 W 1St St
Elmhurst, IL 60126-2641
Phone (630) 833-5110

Other names 1

  • Bloomingdale Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elmhurst Dental Group LTD7 organizations share this tax ID, including this one
Part of
Elmhurst Dental Group LTD

Other organizations with this tax ID 6

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

Locations

290 Springfield Dr
Ste 100
Bloomingdale, IL 60108
Phone (630) 529-0027

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": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253145600000",
    "number": "1871826438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 1ST ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262641",
            "telephone_number": "630-833-5110",
            "fax_number": "630-833-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 SPRINGFIELD DR",
            "address_2": "SUITE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082214",
            "telephone_number": "630-529-0027",
            "fax_number": "630-529-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMHURST DENTAL GROUP, LTD DBA BLOOMINGDALE DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELMHURST DENTAL GROUP, LTD",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-17",
        "status": "A",
        "authorized_official_last_name": "GROH",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-833-5110",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomingdale Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.