Individual provider Active NPI

Kimberley M Latour, DDS

  • Dentist
  • Schaumburg, IL
National Provider Identifier
1912106956
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19-026827 Issued in IL
Practice address
1701 E Woodfield Rd
150
Schaumburg, IL 60173-5905
Phone
(841) 619-0330
Fax
(847) 517-8124
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19-026827 IL Primary

Addresses

Primary practice location

1701 E Woodfield Rd
150
Schaumburg, IL 60173-5905

Mailing address

1701 E Woodfield Rd
150
Schaumburg, IL 60173-5905
Phone (847) 619-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150707002448 IL Order and Referring Only - DentistPractitioner - Dentist 0648582577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19-026827ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
O'Reilly Dental, LLC Past Accepting new patients
Yangbasai Dong DMD PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1912106956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E WOODFIELD RD",
            "address_2": "150",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735905",
            "telephone_number": "847-619-0330",
            "fax_number": "847-517-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E WOODFIELD RD",
            "address_2": "150",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735905",
            "telephone_number": "841-619-0330",
            "fax_number": "847-517-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATOUR",
        "first_name": "KIMBERLEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19-026827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.