ADVANCED ENDODONTICS, PC (NPI# 1588163364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588163364 |
| Entity Type | Organization |
| Organization Name | ADVANCED ENDODONTICS, PC |
| Practice Address |
103 S. Greenleaf Street Suite K Gurnee IL 60031 |
| Mailing Address |
921 Old Trail Rd Higland Park IL 60035 |
| Practice Telephone | 8477820048 |
| Practice Fax Number | 8477820102 |
| Mailing Telephone | 8477820048 |
| Mailing Fax Number | 8477820102 |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |
| Authorized Official Name | DR. JOHN E STUPARITZ (PRESIDENT OWNER DDS) |
| Authorized Official Telephone | 8478407580 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
021.001771 | IL | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.020999 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710594320 | Advanced Endodontics, PC | Dentist | 1500 20th St S, Birmingham, AL 35205-4916 | 2020-09-28 |
| Street Address |
103 S. GREENLEAF STREET SUITE K |
| City | GURNEE |
| State | IL |
| Zip Code | 60031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| 1801167309 | Emily Anne Eichmeier | Social Worker | 4212 Old Grand Ave. Gurnee Counseling, Suite 102, Gurnee, IL 60031 | 2012-01-16 |
| Find all providers in zip 60031 | ||||
| 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 |
|---|---|---|---|---|
| 1619343688 | Tina Khoury | Dentist | 4225 Tiger Lily Ln Apt 404, Gurnee, IL 60031-9641 | 2015-08-13 |
| 1609280080 | Bradley C. Rule, Dds, P.C. | Dentist | 6475 Washington St Ste 101, Gurnee, IL 60031-4404 | 2014-06-13 |
| 1972925584 | Dental Professionals of Illinois, P.C. | Dentist | 6631 Grand Ave Ste 1, Gurnee, IL 60031-5284 | 2014-01-16 |
| 1679877195 | Timothy L. Straka D.d.s., L.L.C. | Dentist | 3 S Greenleaf St Ste L, Gurnee, IL 60031-3377 | 2010-12-23 |
| 1265686976 | Michael Steven Liss | Dentist | 3567 Grand Ave Ste E, Gurnee, IL 60031-4606 | 2008-11-07 |
| 1134377468 | Angie Samuel | Dentist | 6083 Indian Trail Rd, Gurnee, IL 60031-4421 | 2008-08-28 |
| 1164641940 | Unonmosen Eniola Ogufere | Dentist | 6695 Grand Ave, Suite E, Gurnee, IL 60031-5268 | 2007-04-24 |
| 1346467396 | Warren J Smith | Dentist | 36100 Brookside Drive, Ste. Ll40, Gurnee, IL 60031 | 2007-04-19 |
| 1326181967 | Bradley C. Rule | Dentist | 6475 Washington St, Ste 101, Gurnee, IL 60031-4404 | 2007-02-14 |
| 1528119336 | Patricia Lynn Eaton | Dentist | 5649 Manchester Drive, Gurnee, IL 60031 | 2007-01-16 |
| Find all providers in GURNEE | ||||
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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.