Consumate Dental P.C

Primary specialty

DentistTaxonomy code 122300000X

License

019026480 Issued in IL

Legal business name

CONSUMATE DENTAL P.C

Practice address

825 E Rollins Rd
Round Lake Beach, IL 60073-2244

Phone

(773) 398-5822

Fax

(630) 428-2182

NPI assigned

Jun 5, 2012

Last updated

Jun 5, 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. Moeen Ikram

Title

President

Phone

(773) 398-5822

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Harini Katakamsetti

  • Dentist
  • Round Lake Beach, IL
  • NPI 1992240030
  NPD (past)
• Shweta Venugopal

  • Dentist
  • Round Lake Beach, IL
  • NPI 1053856260
  NPD (past)

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1871854042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E ROLLINS RD",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600732244",
            "telephone_number": "773-398-5822",
            "fax_number": "630-428-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E ROLLINS RD",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600732244",
            "telephone_number": "773-398-5822",
            "fax_number": "630-428-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSUMATE DENTAL P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "IKRAM",
        "authorized_official_first_name": "MOEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-398-5822",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Andrew Canty, DMD
• Alma Castrejon, PHARMD
• Chiro One Wellness Center of Round Lake Beach LLC
• Michelle Chisenhall, RDH
• Christina M Circo, RPH
• Patrick Dene Cornet
• County of Lake (Lake County Health Department and Community Health Center)
• Michelle Crutcher, RDH
• Dac Dental PC (Rollins Family Dental Center)
• Daniel & Max, LLC

• Dentist in Round Lake Beach, IL
• Providers in Round Lake Beach, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.