NPIMap

Organization Active NPI

Kathy Pawlksienica DDS PC Dba Prospect Dental

Doing business as Prospect Dental

  • Dentist
  • Mount Prospect, IL
National Provider Identifier
1972616720
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KATHY PAWLKSIENICA DDS PC DBA PROSPECT DENTAL
Doing business as
Prospect Dental
Practice address
259 E Rand Road Suite 110
Mount Prospect, IL 60056
Phone
(847) 890-4444
Fax
(847) 506-0148
NPI assigned
Aug 16, 2006
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
Mrs. Kathy Pawlksienica, DDS
Title
Owner
Phone
(847) 890-4444

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X IL
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X IL Primary

Addresses

Primary practice location

259 E Rand Road Suite 110
Mount Prospect, IL 60056

Mailing address

259 E Rand Road Suite 110
Mount Prospect, IL 60056
Phone (847) 890-4444

Other names 1

  • Prospect Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kathy Pawlksienica DDS PC Dba Prospect Dental2 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.

Locations

259 E Rand Rd
Ste 110
Mt Prospect, IL 60056
Phone (847) 321-9445

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972616720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E RAND ROAD SUITE 110",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "60056",
            "telephone_number": "847-890-4444",
            "fax_number": "847-506-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E RAND ROAD SUITE 110",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "60056",
            "telephone_number": "847-890-4444",
            "fax_number": "847-506-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHY PAWLKSIENICA DDS PC DBA PROSPECT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAWLKSIENICA",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-890-4444",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prospect Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Prospect, 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.