Individual provider Active NPI

Lawrence A Mulvaney, DDS

  • General Practice Dentistry
  • Niles, IL
National Provider Identifier
1992874044
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019020600 Issued in IL
Practice address
7745 N Milwaukee Ave
Niles, IL 60714-4735
Phone
(847) 967-6744
Fax
(847) 967-1460
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019020600 IL Primary

Addresses

Primary practice location

7745 N Milwaukee Ave
Niles, IL 60714-4735

Mailing address

400 Lake Cook Rd Ste 115
Deerfield, IL 60015-4929
Phone (847) 945-3515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019020600ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Galliani Mulvaney & Associates LTD CurrentSince Apr 26, 2020 Accepting new patients
Northwestern Dental Group LTD General Practice Current Accepting new patients
Mulvaney Dental PC General Practice Past Accepting new patients

Locations

400 Lake Cook Rd
Ste 115
Deerfield, IL 60015
Phone (847) 945-3515

7745 N Milwaukee Ave
Niles, IL 60714
Phone (847) 967-6744

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1992874044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LAKE COOK RD STE 115",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154929",
            "telephone_number": "847-945-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7745 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144735",
            "telephone_number": "847-967-6744",
            "fax_number": "847-967-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULVANEY",
        "first_name": "LAWRENCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.