NPIMap

Organization Active NPI

Park Ridge Dental Associates

  • General Practice Dentistry
  • Park Ridge, IL
National Provider Identifier
1992928568
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PARK RIDGE DENTAL ASSOCIATES
Practice address
318 W Touhy Ave
Park Ridge, IL 60068-4205
Phone
(847) 692-2303
Fax
(847) 692-2684
NPI assigned
Apr 11, 2007
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
Brett Donald Anderson, DDSNPI 1679697676
Title
Owner
Phone
(847) 692-2303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X IL Primary

Addresses

Primary practice location

318 W Touhy Ave
Park Ridge, IL 60068-4205

Mailing address

318 W Touhy Ave
Park Ridge, IL 60068-4205
Phone (847) 692-2303

National Provider Directory

National Provider Directory

Locations

318 W Touhy Ave
Park Ridge, IL 60068
Phone (847) 692-2303

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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992928568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 W TOUHY AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684205",
            "telephone_number": "847-692-2303",
            "fax_number": "847-692-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 W TOUHY AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684205",
            "telephone_number": "847-692-2303",
            "fax_number": "847-692-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-692-2303",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, 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.