Organization Active NPI

Samuel Skurie, D.D.S., LTD.

  • Dentist
  • Highland Park, IL
National Provider Identifier
1881182103
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SAMUEL SKURIE, D.D.S., LTD.
Practice address
1770 1St St Ste 450
Highland Park, IL 60035-5602
Phone
(847) 432-0254
NPI assigned
Apr 23, 2018
Last updated
Jun 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Authorized official

Name
Samuel SkurieNPI 1740355049
Title
Owner
Phone
(847) 432-0254

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

1770 1St St Ste 450
Highland Park, IL 60035-5602

Mailing address

170 Lakeside PL
Highland Park, IL 60035-5317
Phone (847) 433-6006

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1881182103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 LAKESIDE PL",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355317",
            "telephone_number": "847-433-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 1ST ST STE 450",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355602",
            "telephone_number": "847-432-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL SKURIE, D.D.S., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "SKURIE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-432-0254"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.