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WINTHROP HARBOR DENTAL CENTER NPI 1306853429


NPI Information

NPI: 1306853429
Provider Name: WINTHROP HARBOR DENTAL CENTER
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
644 SHERIDAN RD
SUITE 105
WINTHROP HARBOR, IL
ZIP 60096
Phone: (847) 872-5626
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WINTHROP HARBOR DENTAL CENTER is a general practice dentist in Winthrop Harbor, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. WINTHROP HARBOR DENTAL CENTER NPI is 1306853429. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

644 SHERIDAN RD
SUITE 105
WINTHROP HARBOR, IL
ZIP 60096-350
Phone: (847) 872-5626
Fax: (847) 746-2900

The provider's authorized official is Michelle L Opelt .
The authorized official title is Business Manager and has the following contact phone number (847) 872-5626.

The enumeration date for this NPI number is 8/2/2006 and was last updated on 11/28/2011.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice019015026ILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1TRI-CAREOTHERILLINOIS603323
2BCBS OF ILOTHERILLINOIS80006341
3UNITED CONCORDIAOTHERILLINOIS603323

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: 5/5/2024

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