Crest Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.027379 Issued in IL

Legal business name

CREST DENTAL LLC

Practice address

1354 W Army Trail Rd
Carol Stream, IL 60188-4836

Phone

(847) 361-2400

Fax

(630) 289-6870

NPI assigned

May 22, 2012

Last updated

May 22, 2012By 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

Dr. Ami K Shah, D.D.S

Title

Dentist

Phone

(847) 361-2400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1033479126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1354 W ARMY TRAIL RD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601884836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 W ARMY TRAIL RD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601884836",
            "telephone_number": "847-361-2400",
            "fax_number": "630-289-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "AMI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-361-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.027379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Margaret Cosentino, ATC
• Melissa Ann Costner, RDH
• Dale Cress, D.C.
• Crest Dental Care PC
• Crest Dental Group PC
• Crestwood Counseling LLC
• Nenita P Cudiamat
• John Rairdon Curphey, MDIV.,M.A.
• Kayla Lynn Czapiewski
• Stephanie Czernek, MOT, OTR/L

• General Practice Dentistry in Carol Stream, IL
• Providers in Carol Stream, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.