Harvest Plaza Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HARVEST PLAZA DENTAL PLLC

Practice address

929 W Wise Rd
Schaumburg, IL 60193-3821

Phone

(847) 895-0485

NPI assigned

Mar 2, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Robert C Stites

Title

Insurance Coordinator

Phone

(630) 869-5857

Specialties & licenses 1

Addresses

Other names 1

• One Good Smile Doing business as

Practitioners 3

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

• Shayan Ali Khan

  • Dentist
  • El Campo, TX
  • NPI 1114403821
  NPD
• Charles Goodsite, DDS

  • General Practice Dentistry
  • Schaumburg, IL
  • NPI 1457515439
  NPD (past)
• Thomas James Seretis, D.D.S.

  • General Practice Dentistry
  • Schaumburg, IL
  • NPI 1477769834
  NPD (past)

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1033704077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 E WOODFIELD RD STE 102",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734955",
            "telephone_number": "630-869-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 W WISE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933821",
            "telephone_number": "847-895-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVEST PLAZA DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "STITES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "630-869-5857",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "One Good Smile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Harris, RBT
• Kelly Jo Harris
• Kenneth Paul Harris, RESPIRATORY THERAPIS
• Traci Harris, NP
• Harry J. Kiriluk DDS LTD
• Sobia Hasan
• Albert Steven Hasson, MD
• Marisa Hatakeyama
• Jenny Hau, DO
• Catherine C Hauser-Meyers, LCPC

• General Practice Dentistry in Schaumburg, IL
• Providers in Schaumburg, 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 Mar 2, 2021; 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.