Dental Smiles of Bolingbrook

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL SMILES OF BOLINGBROOK

Practice address

495 S Weber Rd
Bolingbrook, IL 60490-5504

Phone

(213) 820-6487

NPI assigned

Jul 24, 2020

Last updated

Jul 24, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ali Khan, DDSNPI 1689724684

Title

President

Phone

(630) 723-6333

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ali Mohammed Khan, DDS

  • General Practice Dentistry
  • Aurora, IL
  • NPI 1689724684
  NPD (past) Authorized official
• Sarah Syed

  • General Practice Dentistry
  • Naperville, IL
  • NPI 1518596519
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1003425125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 SABLE OAKS DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645665",
            "telephone_number": "213-820-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 S WEBER RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905504",
            "telephone_number": "213-820-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SMILES OF BOLINGBROOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-723-6333",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deliverrx LLC
• Sophia Deltoro, D.O
• Julie Ann Deluca, RDH
• Sabrina Demski, DPT
• Samantha Dench, DFM
• Alexis Maria Deppen
• Derick Dermatology, PLLC
• Dhccltd
• Konstantia Dickens
• Karen Dickson, MA, CCC-SLP/L

• Dental Clinic/Center in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.