DR. BARRY E BOOTH (NPI# 1770629065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770629065 |
| Entity Type | Individual |
| Full Name | DR. BARRY E BOOTH |
| Credential | D.D.S., M.S. |
| Practice Address |
12635 W 143rd St Homer Glen IL 60491-8381 |
| Practice Telephone | 7083010005 |
| Practice Fax Number | 7083010063 |
| Mailing Telephone | 7083010005 |
| Mailing Fax Number | 7083010063 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508828732 | Barry Frank Booth | Dentist | 6475 Spanish Fort Blvd, Suite H, Spanish Fort, AL 36527-9406 | 2006-04-04 |
| 1033284948 | Barry Lee Booth | Dentist | 6525 Spanish Fort Blvd, Spanish Fort, AL 36527 | 2006-11-24 |
| Street Address |
12635 W 143RD ST |
| City | HOMER GLEN |
| State | IL |
| Zip Code | 60491-8381 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821562323 | Booth Orthodontics LLC | Dentist | 12635 W 143rd St, Homer Glen, IL 60491-8381 | 2019-01-17 |
| 1578036638 | Ryan Elston Booth | Dentist | 12635 W 143rd St, Homer Glen, IL 60491-8381 | 2019-01-10 |
| 1740329093 | Barry E. Booth, D.d.s., M.s. | Dentist | 12635 W 143rd St, Homer Glen, IL 60491-8381 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417490681 | Kellie Calderon | Counselor | 14007 S Bell Rd Ste 183, Homer Glen, IL 60491 | 2016-11-21 |
| 1811249915 | Jasmina Peric | Registered Nurse | 14607 Stonegate Drive, Homer Glen, IL 60491 | 2012-10-12 |
| 1700137783 | Nicole Marie Karn | Physical Therapy Assistant | 14319 Twin Creek Lane, Homer Geln, IL 60491 | 2012-10-01 |
| 1992062061 | South Suburban Hearing, Inc | Hearing Instrument Specialist | 14316 S. Will-cook Rd, Homer Glen, IL 60491 | 2012-04-13 |
| 1336417385 | Crystal Knaack | Pharmacist | 13911 W 167th St, Homer Glen, IL 60491 | 2011-12-06 |
| 1891976429 | Toothworks Inc | Dentist | 12626 W 159th St, Homer Glen, IL 60491 | 2007-11-26 |
| 1972639441 | Barbara A Bayer | Social Worker | 13528 Marissa Ct, Homer Glen, IL 60491 | 2007-02-26 |
| 1093893117 | Daniel L Clark Do Ltd | Family Medicine | 14831 W 159th St, Harris Bank Building, Lockport, IL 60491 | 2006-11-02 |
| 1720006752 | Judith Polkow | Physical Therapist | 14821 S. Founders Crossing, Homer Glen, IL 60491 | 2006-07-17 |
| 1518902188 | Allen Ophthalmic Group | Ophthalmology | 15933 South Bell Road, Homer Glen, IL 60491 | 2006-06-18 |
| Find all providers in zip 60491 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245640424 | Kristina Dragstrem | Dentist | 15776 S Bell Rd, Homer Glen, IL 60491-8400 | 2014-04-28 |
| 1821562323 | Booth Orthodontics LLC | Dentist | 12635 W 143rd St, Homer Glen, IL 60491-8381 | 2019-01-17 |
| 1578036638 | Ryan Elston Booth | Dentist | 12635 W 143rd St, Homer Glen, IL 60491-8381 | 2019-01-10 |
| 1740329093 | Barry E. Booth, D.d.s., M.s. | Dentist | 12635 W 143rd St, Homer Glen, IL 60491-8381 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427670421 | Braces By Barnes | Dentist | 1335 E 87th St Ste B, Chicago, IL 60619-7036 | 2020-05-12 |
| 1790310431 | Gregory D Long II | Dentist | 7131 N Knoxville Ave Ste B, Peoria, IL 61614-2088 | 2020-03-03 |
| 1073147682 | Collinsville Orthodontics Pllc | Dentist | 93 Crestmoor St, Collinsville, IL 62234-4952 | 2020-02-24 |
| 1740812494 | Bankhead Alton Orthodontics PC | Dentist | 2828 Homer Adams Pkwy, Alton, IL 62002-4855 | 2020-02-11 |
| 1336779164 | Orthodontic Experts, Ltd | Dentist | 2987 Kirk Rd Ste 103a, Aurora, IL 60502-6014 | 2020-01-21 |
| 1922645308 | Riddhi J Desai Dmd Pllc | Dentist | 727 W Madison St Apt 1208, Chicago, IL 60661-2409 | 2019-12-04 |
| 1295379691 | Orthodontic Experts, Ltd | Dentist | 1351 N Larkin Ave, Joliet, IL 60435-3753 | 2019-10-30 |
| 1407409071 | Barysenka LLC | Dentist | 124 N California St, Sycamore, IL 60178-1402 | 2019-07-22 |
| 1346806577 | Pulaski Smiling Dental P.C. | Dentist | 5540 S Pulaski Rd Fl 1, Chicago, IL 60629-4418 | 2019-05-13 |
| 1750944252 | Candid Illinois, Pllc | Dentist | 750 N Franklin St Fl Stc2, Chicago, IL 60654-6263 | 2019-04-19 |
| Find all providers with the same taxonomy | ||||
| City | HOMER GLEN |
| Zip Code | 60491 |
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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.