McHenry Dental Associates

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019021569 Issued in IL

Legal business name

MCHENRY DENTAL ASSOCIATES

Practice address

1315 N Riverside Dr
McHenry, IL 60050-4509

Phone

(815) 385-1360

NPI assigned

Jun 13, 2018

Organization subpart

No

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

Authorized official

Name

Kristy Wolter

Title

Insurance Manager

Phone

(630) 869-5857

Specialties & licenses 1

Addresses

Practitioners 2

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

• Mary Chiakulas, D.D.S.

  • Dentist
  • McHenry, IL
  • NPI 1215272679
  NPD (past)
• Thomas Leland Gough, D.D.S.

  • Dentist
  • McHenry, IL
  • NPI 1871838227
  NPD (past)

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1982197984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 E WOODFIELD RD STE 102",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734955",
            "telephone_number": "630-339-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 N RIVERSIDE DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504509",
            "telephone_number": "815-385-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCHENRY DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "WOLTER",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "630-869-5857"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019021569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McHenry C C School Dist 15
• McHenry Chiropractic PLLC
• McHenry Community High School
• McHenry County Mental Health Board
• McHenry County Physical Therapy, Inc.
• McHenry Dental Center, LTD.
• McHenry Dental Specialists LLC
• McHenry Dialysis Center LLC
• McHenry Medical Center SC
• McHenry Medical Center, S.C.

• Dental Clinic/Center in McHenry, IL
• Providers in McHenry, 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 13, 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.