WINTHROP HARBOR DENTAL CENTER (NPI# 1306853429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306853429 |
Entity Type | Organization |
Organization Name | WINTHROP HARBOR DENTAL CENTER |
Practice Address |
644 Sheridan Rd Suite 105 Winthrop Harbor IL 60096-1350 |
Practice Telephone | 8478725626 |
Practice Fax Number | 8477462900 |
Mailing Telephone | 8478725626 |
Mailing Fax Number | 8477462900 |
Enumeration Date | 2006-08-02 |
Last Update Date | 2011-11-28 |
Authorized Official Name | MRS. MICHELLE L OPELT (BUSINESS MANAGER) |
Authorized Official Telephone | 8478725626 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
019015026 | IL | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 603323 | UNITED CONCORDIA | 01 |
IL | 80006341 | BCBS OF IL | 01 |
IL | 603323 | TRI-CARE | 01 |
Street Address |
644 SHERIDAN RD SUITE 105 |
City | WINTHROP HARBOR |
State | IL |
Zip Code | 60096-1350 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427071828 | Michael A. Damko | Dentist | 644 Sheridan Rd, Suite 105, Winthrop Harbor, IL 60096-1350 | 2006-07-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831332469 | Winthrop Harbor School District #1 | Local Education Agency (LEA) | 500 North Ave, Winthrop Harbor, IL 60096-1186 | 2009-04-13 |
1720501380 | Lion Grenader | Dentist | 644 Sheridan Rd # D, Winthrop Harbor, IL 60096-1350 | 2017-07-25 |
1104171917 | Susan R. Davis Therapies, Inc. | Community/Behavioral Health | 3804 11th St, Winthrop Harbor, IL 60096-1461 | 2012-07-17 |
1952848756 | Joan Thornton | Licensed Practical Nurse | 743 Russell Ave, Winthrop Harbor, IL 60096-1544 | 2017-01-31 |
1871528133 | Village of Winthrop Hbr | Ambulance | 830 Sheridan Rd, Winthrop Harbor, IL 60096-1632 | 2006-07-12 |
1043219652 | Harbor Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1707 7th St, Suite 4, Winthrop Harbor, IL 60096-1656 | 2005-07-15 |
1992844773 | Jackie Lynne Schilling | Pharmacist | 1707 7th St, Suite 4, Winthrop Harbor, IL 60096-1656 | 2007-02-06 |
1013056605 | Louis M. Abboud | Pharmacist | 1707 7th St, Winthrop Harbor, IL 60096-1656 | 2007-02-06 |
1205973609 | Harbor Pharmacy Inc | Pharmacy | 1707 7th St, Suite 4, Winthrop Harbor, IL 60096-1656 | 2007-02-01 |
1518223700 | Kathryn Lisa Hickey | Specialist/Technologist | 944 Landon Ave, Winthrop Harbor, IL 60096-1732 | 2012-04-02 |
Find all providers in zip 60096 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
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. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104425230 | Sundeep Franklin Dmd & Daiana Capota Dmd Pllc | Dentist | 320 N Mclean Blvd Ste B, Elgin, IL 60123-3220 | 2020-10-20 |
1801403555 | Stephanie Elizabeth Miller | Dentist | 2220 Sisters Ave, Naperville, IL 60564-4394 | 2020-09-27 |
1417564121 | Gursimran Reen, Dmd LLC | Dentist | 29 S Webster St Ste 108, Naperville, IL 60540-5353 | 2020-09-26 |
1285240531 | Summit Dental Center LLC | Dentist | 7710 W 62nd Pl, Summit, IL 60501-1702 | 2020-09-22 |
1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
1932713583 | Kevin G Reardon | Dentist | 479 S Spring Rd, Elmhurst, IL 60126-3857 | 2020-09-01 |
1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
1548870884 | Daniel Patrick Jurgens | Dentist | 2 N Country Club Rd Ste 2, Decatur, IL 62521-4174 | 2020-08-02 |
1184233934 | Shawna Jade Dudovitz | Dentist | 309 Tamarack Ln, Shiloh, IL 62269-2993 | 2020-07-28 |
1417565748 | Robert Hails | Dentist | 3540 N Belt W Ste B, Belleville, IL 62226-5975 | 2020-07-22 |
Find all providers with the same taxonomy |
City | WINTHROP HARBOR |
Zip Code | 60096 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.