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MEADOW LAKE DENTAL LLC NPI 1972904282


NPI Information

NPI: 1972904282
Provider Name: MEADOW LAKE DENTAL LLC
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
3941 75TH ST
SUITE 102
AURORA, IL
ZIP 60504
Phone: (630) 851-5130
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MEADOW LAKE DENTAL LLC is a preferred provider organization in Aurora, IL. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. MEADOW LAKE DENTAL LLC NPI is 1972904282. The provider is registered as an organization entity type.

The provider's business location address is:

3941 75TH ST
SUITE 102
AURORA, IL
ZIP 60504-924
Phone: (630) 851-5130
Fax: (630) 851-5739

The provider's authorized official is Alan J Acierno .
The authorized official title is Manager and has the following contact phone number (630) 339-3172.

The enumeration date for this NPI number is 9/7/2014 and was last updated on 9/7/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305R00000XPreferred Provider Organization019021506ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11144341108OTHERILLINOISNPPES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.