Advanced Dental Care of Cicero, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ADVANCED DENTAL CARE OF CICERO, LLC

Doing business as

Advanced Dental Care of Cicero

Practice address

130 W Jackson St
Cicero, IN 46034-5005

Phone

(317) 509-6499

NPI assigned

Mar 8, 2024

Last updated

Mar 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Denise Bever

Title

Regional Manager

Phone

(317) 509-6499

Specialties & licenses 1

Addresses

Other names 1

• Advanced Dental Care of Cicero Doing business as

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1992563696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W JACKSON ST",
            "city": "CICERO",
            "state": "IN",
            "postal_code": "460345005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W JACKSON ST",
            "city": "CICERO",
            "state": "IN",
            "postal_code": "460345005",
            "telephone_number": "317-509-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL CARE OF CICERO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "BEVER",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "317-509-6499"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Care of Cicero",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ellen R. Bell, M.A.,CCC/SLP
• Jessica Ruth Bleyle, NP-C
• Cicero Chiropractic Inc.
• Cicero Corporation (Cicero Fire Department)
• Cicero Family Dental LLC

• Dental Clinic/Center in Cicero, IN
• Providers in Cicero, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.