Dexter Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DEXTER DENTAL LLC

Practice address

47 Clock Tower Plaza
Elgin, IL 60120-7800

Phone

(847) 695-8780

Fax

(847) 695-0939

NPI assigned

Jun 30, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Brandon Alexander Taylor, CPCS

Title

Credentialing & Payer Relations Man

Phone

(847) 453-7396

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1942462080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 EAST ALGONQUIN ROAD",
            "address_2": "SUITE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "847-453-7396",
            "fax_number": "847-453-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 CLOCK TOWER PLAZA",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601207800",
            "telephone_number": "847-695-8780",
            "fax_number": "847-695-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXTER DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CREDENTIALING & PAYER RELATIONS MAN",
        "authorized_official_telephone_number": "847-453-7396",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPCS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026920",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Grace Dewar, BSW
• Tracey Dewis, BCBA
• Megan Dewitt
• Dexter Dental 2 LLC (Familia Dental)
• Dexter Dental 3 LLC
• Supreet Kaur Dhaliwal
• Anik Dharia, PHARMD
• Sunita Dhawan
• Sejal Dholakia
• Dhrulata R Shah MDSC

• Dental Clinic/Center in Elgin, IL
• Providers in Elgin, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.