1841312576 NPI number — LAURENCE A. SEXTON, D.D.S., PC

Table of content: (NPI 1841312576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841312576 NPI number — LAURENCE A. SEXTON, D.D.S., PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAURENCE A. SEXTON, D.D.S., PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841312576
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
541 SULLIVAN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60506-1406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-897-1156
Provider Business Mailing Address Fax Number:
630-896-5374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
541 SULLIVAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60506-1406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-897-1156
Provider Business Practice Location Address Fax Number:
630-896-5374
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SEXTON
Authorized Official First Name:
LAURENCE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
630-897-1156

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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