COUNTRY COURT DENTAL CARE (NPI# 1114492576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114492576 |
| Entity Type | Organization |
| Organization Name | COUNTRY COURT DENTAL CARE |
| Practice Address |
1880 W Winchester Rd Ste 113 Libertyville IL 60048-5321 |
| Practice Telephone | 8476805141 |
| Practice Fax Number | 8476805181 |
| Mailing Telephone | 8476805141 |
| Mailing Fax Number | 8476805181 |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2018-10-11 |
| Authorized Official Name | DR. BOZENA SUTKOWSKI (DENTIST) |
| Authorized Official Telephone | 8476805141 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Street Address |
1880 W WINCHESTER RD STE 113 |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-5321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639629645 | Ala Dean Attar Dmd PC | Dentist | 712 Florsheim Dr, Suite # 12, Libertyville, IL 60048-5270 | 2016-10-13 |
| 1063763761 | Linda M Sommercorn | Dentist | 1216 American Way Ste 104, Libertyville, IL 60048-3940 | 2012-09-21 |
| 1770795676 | Stuart M Schwartz | Dentist | 611 S Milwaukee Ave, Libertyville, FL 60048 | 2007-05-04 |
| 1902999873 | Diana Lacy | Dentist | 747 N Milwaukee Ave, Suite 103, Libertyville, IL 60048 | 2006-10-02 |
| 1003917915 | Lisa Mostowfi Konz | Dentist | 747 N Milwaukee Ave Suite 103, Libertyville, IL 60048 | 2006-09-25 |
| 1851407647 | Claude Charles Lerose | Dentist | 1900 Hollister Drive, Ste #190, Libertyville, IL 60048 | 2006-08-22 |
| 1689789745 | Eleanor B Merrill Chudy | Dentist | 1655 N Milwaukee Ave, Libertyville, IL 60048-1314 | 2006-08-20 |
| 1952415903 | David Cary Mcclenahan | Dentist | 755 South Milwaukee Avenue, Suite 120, Libertyville, IL 60048-3267 | 2006-08-18 |
| 1770506776 | Evan B Goodman | Dentist | 115 W Maple Ave, Libertyville, IL 60048-2119 | 2006-07-25 |
| 1356969257 | Garrett David Obenauf | Dentist | 1109 W Park Ave, Libertyville, IL 60048-2552 | 2020-07-08 |
| Find all providers in LIBERTYVILLE | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
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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.