Candace Marie Opon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-023866 Issued in IL

Practice address

690 N Il Route 31
Crystal Lake, IL 60012-3790

Phone

(815) 477-2177

Fax

(815) 477-2671

NPI assigned

May 4, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1053603365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 N. ROUTE 31",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60012",
            "telephone_number": "815-477-2177",
            "fax_number": "815-477-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 N IL ROUTE 31",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123790",
            "telephone_number": "815-477-2177",
            "fax_number": "815-477-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPON",
        "first_name": "CANDACE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-023866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie L Olson
• Abiodun Emmanuel Oludaisi
• Afsheen Mumtaz Ommar, D.D.S.
• Onething Care, Inc.
• Open Advanced MRI of Crystal Lake, LLC
• Kyle Opperman-Hill
• Options & Advocacy
• Options & Advocacy for McHenry Co. Inc.
• Options & Advocacy for McHenry Co. Inc.
• Options & Advocacy for McHenry County

• General Practice Dentistry in Crystal Lake, IL
• Providers in Crystal Lake, 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 4, 2011; 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.