Provider Demographics
NPI:1033496112
Name:NEXTGEN ORTHODONTICS PC
Entity Type:Organization
Organization Name:NEXTGEN ORTHODONTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:
Authorized Official - First Name:NERITA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRACHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-947-2651
Mailing Address - Street 1:201 E STRONG ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-2979
Mailing Address - Country:US
Mailing Address - Phone:847-947-2651
Mailing Address - Fax:847-243-8668
Practice Address - Street 1:201 E STRONG ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-2979
Practice Address - Country:US
Practice Address - Phone:847-947-2651
Practice Address - Fax:847-243-8668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty