PROCARE DENTAL GROUP, P.C. (NPI# 1124185467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124185467 |
| Entity Type | Organization |
| Organization Name | PROCARE DENTAL GROUP, P.C. |
| Other Organization Name | GRAND DENTISTRY |
| Practice Address |
5445 Grand Ave Ste 202 Gurnee IL 60031-1725 |
| Mailing Address |
605 E Algonquin Rd Ste 300 Arlington Heights IL 60005-4373 |
| Practice Telephone | 8472442775 |
| Practice Fax Number | 8472442777 |
| Mailing Telephone | 8476401112 |
| Mailing Fax Number | 8476401107 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT G. BRUNETTI (C.E.O.) |
| Authorized Official Telephone | 8476401112 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | IL | Dental Providers |
| Other Name | Type Code |
|---|---|
| Grand Dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528246212 | Procare Dental Group, P.C. | Dentist | 434 West Ontario Street, Ste 300, Chicago, IL 60654 | 2008-02-05 |
| 1669539904 | Procare Dental Group, P.C. | Dentist | 805 Mchenry Ave, Crystal Lake, IL 60014-9794 | 2007-01-03 |
| 1821160904 | Procare Dental Group, P.C. | Dentist | 1057 N Northwest Hwy, Park Ridge, IL 60068-1805 | 2006-11-14 |
| 1114975828 | Procare Dental Group, P.C. | Dentist | 605 E Algonquin Rd, Suite 300, Arlington Heights, IL 60005-4373 | 2006-05-05 |
| 1841357084 | Procare Dental Group, P.C. | Dentist | 820 Davis St, Ste 460, Evanston, IL 60201-4431 | 2007-01-03 |
| 1578620712 | Procare Dental Group, P.C. | Dentist | 2266 N Lincoln Ave, Unit 1, Chicago, IL 60614-3718 | 2007-01-03 |
| 1912064155 | Procare Dental Group, P.C. | Dentist | 115 S Grove Ave, Ste 204, Elgin, IL 60120-6430 | 2007-01-03 |
| 1649337882 | Procare Dental Group, P.C. | Dentist | 5301 E State St, Ste 307a, Rockford, IL 61108-2901 | 2007-01-03 |
| 1811054059 | Procare Dental Group, P.C. | Dentist | 715 Ela Rd, Ste 1a, Lake Zurich, IL 60047-6300 | 2007-01-03 |
| 1215094883 | Procare Dental Group, P.C. | Dentist | 7 Blanchard Cir, Ste Llg, Wheaton, IL 60187-1037 | 2007-01-03 |
| Street Address |
5445 GRAND AVE STE 202 |
| City | GURNEE |
| State | IL |
| Zip Code | 60031-1725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346239902 | Shuba Anantha | Dentist | 5445 Grand Ave, Gurnee, IL 60031-1725 | 2005-10-17 |
| 1376771345 | Fred Peter Biasiello IIi | Dentist | 5445 Grand Ave, Ste 202, Gurnee, IL 60031-1725 | 2009-06-29 |
| 1841391232 | Nader Gill | Dentist | 5445 Grand Ave, Suite 204, Gurnee, IL 60031-1725 | 2006-09-26 |
| 1942244322 | Jeffrey I Glassman | Dentist | 5445 Grand Ave, Suite 202, Gurnee, IL 60031-1725 | 2006-06-15 |
| 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 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 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 |
| Find all providers in zip 60031 | ||||
| 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 |
|---|---|---|---|---|
| 1538729678 | Carol L Jeffries | Dentist | 6300 Grand Ave, Gurnee, IL 60031-4538 | 2019-06-20 |
| 1962834341 | Michelle Marie Romeo | Dentist | 2175 Greystem Cir, Apt #301, Gurnee, IL 60031-9365 | 2013-08-07 |
| 1821257007 | Catherine Dang-chau Phan | Dentist | 4949 Grand Ave Suite 7 A, Gurnee, IL 60031-1821 | 2008-06-03 |
| 1013130657 | Timothy Lars Straka | Dentist | 3 S Greenleaf Ave, Suite L, Gurnee, IL 60031 | 2007-04-11 |
| 1962527127 | The Family Dentists Ltd | Dentist | 5649 Manchester Dr, Gurnee, IL 60031-6109 | 2007-03-20 |
| 1376166017 | Yousif Tolla | Dentist | 6300 Grand Ave, Gurnee, IL 60031-4538 | 2020-05-27 |
| 1396292884 | Dental Associates of South Ridge, P.C. | Dentist | 6121 Washington St, #202, Gurnee, IL 60031-5305 | 2016-09-01 |
| 1386007490 | Dr. Ogufere Dds, P.c | Dentist | 6695 Grand Ave, Suite E, Gurnee, IL 60031-5268 | 2016-04-05 |
| 1639546823 | Family Smile Center,inc. | Dentist | 5250 Grand Ave, Ste-10, Gurnee, IL 60031-1877 | 2015-08-24 |
| 1780075655 | Ariata Dental | Dentist | 495 N Riverside Dr, #211, Gurnee, IL 60031-5908 | 2015-02-12 |
| 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.