MR. LEE R BOMGAARS (NPI# 1710045489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710045489 |
| Entity Type | Individual |
| Full Name | MR. LEE R BOMGAARS |
| Credential | DDS |
| Practice Address |
2634 Grand Ave #106 Waukegan IL 60085-2458 |
| Practice Telephone | 8476627588 |
| Practice Fax Number | 8476623843 |
| Mailing Telephone | 8476627588 |
| Mailing Fax Number | 8476623843 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
21000637 | IL | Dental Providers |
| Street Address |
2634 GRAND AVE #106 |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-2458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144226762 | Joseph E Frydman | Ophthalmology | 2634 Grand Ave, Ste 201, Waukegan, IL 60085-2460 | 2005-06-28 |
| 1497085906 | Northwest Sleep Provider Inc. | Durable Medical Equipment & Medical Supplies | 2634 Grand Ave, Suite 107, Waukegan, IL 60085-2458 | 2010-01-05 |
| 1528220316 | Center for Neuro-diagnostic Testing, Inc. | Specialist/Technologist, Other | 2634 Grand Ave, Suite #101, Waukegan, IL 60085-2458 | 2008-07-02 |
| 1043481765 | Martha E. Diaz D.d.s., P.C. | Preferred Provider Organization | 2634 Grand Ave, Suite 207, Waukegan, IL 60085-2458 | 2008-03-20 |
| 1851502033 | David Lee Gaston | Dentist | 2634 Grand Ave, Suite 204, Waukegan, IL 60085-2458 | 2007-05-27 |
| 1114143088 | Spine & Nerve Testing Center | Specialist/Technologist, Other | 2634 Grand Ave, Suite #101, Waukegan, IL 60085-2458 | 2007-04-18 |
| 1104928688 | Alyson Genell Marsalis | Counselor | 2634 Grand Ave, Suite 107, Waukegan, IL 60085-2458 | 2006-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
| Find all providers in zip 60085 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709433 | Children's Center for Dentistry | Dentist | 314 Susan Dr, Normal, IL 61761-6206 | 2020-10-26 |
| 1073125746 | Jessica Mattern Dds, Pllc | Dentist | 326 W Burlington Ave, La Grange, IL 60525-2363 | 2020-08-23 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1710450754 | Drs Selberg & Rice Pllc | Dentist | 4945 Stone Falls Ctr Ste B, O Fallon, IL 62269-7801 | 2019-01-02 |
| 1821583634 | Dentalgenix | Dentist | 113 E Schaumburg Rd, Schaumburg, IL 60194-3518 | 2018-06-25 |
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1942740006 | Dhwani M. Joshi | Dentist | 195 S Rand Rd Ste 110, Lake Zurich, IL 60047-2205 | 2017-03-08 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1669839593 | Algonquin Kids Dentistry, Inc | Dentist | 4097 W Algonquin Rd, Algonquin, IL 60102-9401 | 2016-01-22 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
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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.