NPIMap

Organization Active NPI

Ashley Family Dental, LTD

  • General Practice Dentistry
  • Waukegan, IL
National Provider Identifier
1902010317
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ASHLEY FAMILY DENTAL, LTD
Practice address
2504 Washington St
Suite 503
Waukegan, IL 60085
Phone
(847) 244-0414
Fax
(847) 244-3104
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joo Han Kwon, D.D.S.
Title
President
Phone
(847) 244-0414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X IL Primary

Addresses

Primary practice location

2504 Washington St
Suite 503
Waukegan, IL 60085

Mailing address

2504 Washington St
Suite 503
Waukegan, IL 60085
Phone (847) 244-0414

National Provider Directory

National Provider Directory
Tax ID family
Ashley Family Dental LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902010317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 WASHINGTON ST",
            "address_2": "SUITE 503",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-244-0414",
            "fax_number": "847-244-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 WASHINGTON ST",
            "address_2": "SUITE 503",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-244-0414",
            "fax_number": "847-244-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY FAMILY DENTAL, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "JOO",
        "authorized_official_middle_name": "HAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-244-0414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.