Edc of Downers Grove PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

EDC OF DOWNERS GROVE PLLC

Doing business as

Dentique - Downers Grove

Practice address

4121 Fairview Ave Ste 205
Downers Grove, IL 60515-2267

Phone

(630) 968-8439

Fax

(630) 968-7259

NPI assigned

Sep 8, 2021

Last updated

Apr 25, 2023By 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

Pradeep Khurana

Title

Owner

Phone

(312) 399-9595

Specialties & licenses 1

Addresses

Other names 1

• Dentique - Downers Grove Doing business as

Practitioners 1

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.

• Mazar Shuaipaj, DDS

  • Dentist
  • Downers Grove, IL
  • NPI 1205993193
  NPD (past)

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1073282661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 FAIRVIEW AVE STE 205",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152267",
            "telephone_number": "630-968-8439",
            "fax_number": "630-968-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 FAIRVIEW AVE STE 205",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152267",
            "telephone_number": "630-968-8439",
            "fax_number": "630-968-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDC OF DOWNERS GROVE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-08",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "KHURANA",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-399-9595"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentique - Downers Grove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica E Dyrek, LCPC
• Jill V. Dziak, P.T.A.
• Cassidy Eastman
• Alyssa A Eckert, NP
• Carolyn Eckert
• Mariah Eddie
• Edward Hines Veteran's Hospital
• Anna Egofske
• Christine M Ekis, OTR
• Chloe Marie El-Atoum, M.D.

• Dentist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.