NORTHWESTERN DENTURE CLINIC LLC (NPI# 1932472743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932472743 |
| Entity Type | Organization |
| Organization Name | NORTHWESTERN DENTURE CLINIC LLC |
| Other Organization Name | CROSSROADS OF AMERICAN DENTAL |
| Practice Address |
1721 Sibley Blvd Calumet City IL 60409-2240 |
| Practice Telephone | 7088681771 |
| Mailing Telephone | 7088681771 |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |
| Authorized Official Name | DR. INCHUN YANG (OWNER) |
| Authorized Official Telephone | 7088681771 |
| Authorized Official Credential | D.D.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
19025360 | IL | Dental Providers |
| Other Name | Type Code |
|---|---|
| crossroads of american dental | Doing Business As Name - Organization |
| Street Address |
1721 SIBLEY BLVD |
| City | CALUMET CITY |
| State | IL |
| Zip Code | 60409-2240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366589871 | Inchun Yang | Dentist | 1721 Sibley Blvd, Calumet City, IL 60409-2240 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689159832 | Victory Pharmacy of Decatur Inc | Pharmacy | 1837 River Oaks Rd, Calumet City, IL 60409 | 2018-10-03 |
| 1801336961 | It's About Change Sober Living, Inc. | Community/Behavioral Health | 1604 Horbor St., Calumet City, IL 60409 | 2017-03-08 |
| 1750832986 | Jeffrey Mcneil | Social Worker | 660 Memorial Dr., Calumet City, IL 60409 | 2016-10-24 |
| 1578855219 | Cherechi V Onyenso | Nurse Practitioner | 1473 Ring Ring Road, Great Heights Family Medicine, Calumet City, IL 60409 | 2011-05-13 |
| 1205097607 | Michael Peter Weisberg | Ophthalmology | 1700 East West Road, Calumet City, IL 60409 | 2008-06-19 |
| 1861694333 | County of Cook | Local Education Agency (LEA) | 1255 Superior Ave, Calumet City, IL 60409 | 2007-06-05 |
| 1689875585 | Calumet City School District #155 | Local Education Agency (LEA) | Memorial Dr and Superior, Calumet City, IL 60409 | 2007-05-29 |
| 1932224185 | Micah K Swansey Sr. | Psychologist | 593 Burnham Avenue, Calumet City, IL 60409 | 2007-03-20 |
| 1184768210 | Beverly Williamson | Optometrist | 200 River Oaks Drive, Calumet City, IL 60409 | 2007-02-20 |
| 1205978863 | Dillons Dental Services LLC | Dentist | 2000 E 159th St, Calumet City, IL 60409 | 2007-02-12 |
| Find all providers in zip 60409 | ||||
| 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 |
|---|---|---|---|---|
| 1205218617 | Jeff D Langefeld | Dentist | 1469 Ring Rd, Calumet City, IL 60409-5459 | 2015-06-22 |
| 1811156839 | Jerry Wayne Dillon | Dentist | 2000 River Oaks Dr, Calumet City, IL 60409-5074 | 2008-06-05 |
| 1669688875 | Mantis Dentistry | Dentist | 796 State Line Rd, Calumet City, IL 60409-4643 | 2007-05-15 |
| 1366589871 | Inchun Yang | Dentist | 1721 Sibley Blvd, Calumet City, IL 60409-2240 | 2007-01-31 |
| 1861415960 | Stephen Craig Anderson | Dentist | 542 Pulaski Rd, Calumet City, IL 60409-4121 | 2006-07-26 |
| 1568627776 | Jiana P Panos | Dentist | 1583 Huntington Dr, Calumet City, IL 60409-5440 | 2008-07-28 |
| 1710193917 | Konstantino J Mantis | Dentist | 796 State Line Rd, Calumet City, IL 60409-4643 | 2007-05-15 |
| 1316000532 | David Yu | Dentist | 97 Paxton Ave, Calumet City, IL 60409-1509 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425230 | Sundeep Franklin Dmd & Daiana Capota Dmd Pllc | Dentist | 320 N Mclean Blvd Ste B, Elgin, IL 60123-3220 | 2020-10-20 |
| 1801403555 | Stephanie Elizabeth Miller | Dentist | 2220 Sisters Ave, Naperville, IL 60564-4394 | 2020-09-27 |
| 1417564121 | Gursimran Reen, Dmd LLC | Dentist | 29 S Webster St Ste 108, Naperville, IL 60540-5353 | 2020-09-26 |
| 1285240531 | Summit Dental Center LLC | Dentist | 7710 W 62nd Pl, Summit, IL 60501-1702 | 2020-09-22 |
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1932713583 | Kevin G Reardon | Dentist | 479 S Spring Rd, Elmhurst, IL 60126-3857 | 2020-09-01 |
| 1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
| 1548870884 | Daniel Patrick Jurgens | Dentist | 2 N Country Club Rd Ste 2, Decatur, IL 62521-4174 | 2020-08-02 |
| 1184233934 | Shawna Jade Dudovitz | Dentist | 309 Tamarack Ln, Shiloh, IL 62269-2993 | 2020-07-28 |
| 1417565748 | Robert Hails | Dentist | 3540 N Belt W Ste B, Belleville, IL 62226-5975 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
| City | CALUMET CITY |
| Zip Code | 60409 |
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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.