NPIMap

Organization Active NPI

Elmhurst Dental Group, LTD. Dba St. Charles Dental

Doing business as St. Charles Dental

  • General Practice Dentistry
  • St Charles, IL
National Provider Identifier
1891028452
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ELMHURST DENTAL GROUP, LTD. DBA ST. CHARLES DENTAL
Doing business as
St. Charles Dental
Practice address
2455 Dean St
Unit E
St Charles, IL 60175-4830
Phone
(630) 377-7760
Fax
(630) 377-7785
NPI assigned
Sep 15, 2009
Last updated
Sep 15, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
ELMHURST DENTAL GROUP, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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

Authorized official

Name
Dr. Lawrence P GrohNPI 1639236334
Title
Owner
Phone
(630) 833-5110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

2455 Dean St
Unit E
St Charles, IL 60175-4830

Mailing address

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

Other names 1

  • St. Charles Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elmhurst Dental Group7 organizations share this tax ID, including this one
Part of
Elmhurst Dental Group

Other organizations with this tax ID 6

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

Locations

2455 Dean St
Unit E
St Charles, IL 60175
Phone (620) 377-7760

Practitioners & affiliated clinicians

Practitioners 3

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": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1891028452",
    "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": "2455 DEAN ST",
            "address_2": "UNIT E",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601754830",
            "telephone_number": "630-377-7760",
            "fax_number": "630-377-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMHURST DENTAL GROUP, LTD. DBA ST. CHARLES DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELMHURST DENTAL GROUP, LTD",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "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": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Charles Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.