NPIMap

Organization Active NPI

My Smile Inc

  • Dentist
  • Des Plaines, IL
National Provider Identifier
1023549078
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030623 Issued in IL
Legal business name
MY SMILE INC
Doing business as
Smiles of Des Plaines
Practice address
1475 E Oakton St
Suite 2
Des Plaines, IL 60018-2166
Phone
(224) 443-4988
NPI assigned
Mar 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Authorized official

Name
Dr. Hidayathulla Khan, DMDNPI 1699128082
Title
President
Phone
(224) 766-9876

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019030623 IL Primary

Addresses

Primary practice location

1475 E Oakton St
Suite 2
Des Plaines, IL 60018-2166

Mailing address

6147 Lincoln Ave Unit E
Morton Grove, IL 60053-2900

Other names 1

  • Smiles of Des Plaines Doing business as

National Provider Directory

National Provider Directory

Locations

1475 E Oakton St
Ste 2
Des Plaines, IL 60018
Phone (224) 443-4988

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1023549078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6147 LINCOLN AVE UNIT E",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 E OAKTON ST",
            "address_2": "SUITE 2",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600182166",
            "telephone_number": "224-443-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY SMILE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "HIDAYATHULLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-766-9876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles of Des Plaines",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.