NPIMap

Organization Active NPI

Tru Dental Illinois, P.C.

Doing business as Tru Family Dental - Flossmoor

  • General Practice Dentistry
  • Flossmoor, IL
National Provider Identifier
1912599176
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TRU DENTAL ILLINOIS, P.C.
Doing business as
Tru Family Dental - Flossmoor
Practice address
19509 Governors Hwy
Flossmoor, IL 60422-2097
Phone
(708) 647-7509
NPI assigned
Feb 9, 2021
Last updated
Feb 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
TRU DENTAL ILLINOIS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

19509 Governors Hwy
Flossmoor, IL 60422-2097

Mailing address

19509 Governors Hwy
Flossmoor, IL 60422-2097
Phone (708) 647-7509

Other names 1

  • Tru Family Dental - Flossmoor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tru Dental Illinois PC8 organizations share this tax ID, including this one
Part of
Tru Dental Illinois PC

Other organizations with this tax ID 7

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": "1612828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1912599176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19509 GOVERNORS HWY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222097",
            "telephone_number": "708-647-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19509 GOVERNORS HWY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222097",
            "telephone_number": "708-647-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRU DENTAL ILLINOIS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRU DENTAL ILLINOIS, P.C.",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tru Family Dental - Flossmoor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flossmoor, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.