Southwest Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019029805 Issued in IL

Legal business name

SOUTHWEST FAMILY DENTAL

Practice address

165 S Marley Rd
New Lenox, IL 60451-6045

Phone

(815) 485-3449

NPI assigned

Sep 6, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Brendan D McGrawNPI 1649684507

Title

Owner

Phone

(815) 485-3449

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Brendan McGraw, D.M.D.

  • General Practice Dentistry
  • New Lenox, IL
  • NPI 1649684507
  NPD (past) Authorized official

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1982186896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 S MARLEY RD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513302",
            "telephone_number": "815-485-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S MARLEY RD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604516045",
            "telephone_number": "815-485-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "MCGRAW",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-485-3449",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019029805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanel Smith, FNP-C, PMHNP-C
• Jamie Lynn Smith, ATC
• Meagan Ryan Solava, PHARMD
• Skylar Rose Sones
• Southwest Dermatology
• Danielle Sparacino
• Robin Marie Spatola, APRN
• Jessica Lynn Sredzinski, LCSW
• Mitchell Starcevich, RN
• Jaime Jolene Steinberg, COTA

• Dental Clinic/Center in New Lenox, IL
• Providers in New Lenox, 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 Sep 6, 2018; 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.