NPIMap

Organization Active NPI

Euclid Advanced Dentistry, P.C

  • Dentist
  • Mount Prospect, IL
National Provider Identifier
1093954091
Registry record updated Feb 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027311 Issued in IL
Legal business name
EUCLID ADVANCED DENTISTRY, P.C
Practice address
409 E Euclid Ave Ste B
Mount Prospect, IL 60056-1214
Phone
(847) 368-0200
NPI assigned
Feb 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2009

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

Authorized official

Name
Saba Khan
Title
President
Phone
(847) 368-0200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 019027311 IL Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 021002216 IL

Addresses

Primary practice location

409 E Euclid Ave Ste B
Mount Prospect, IL 60056-1214

Mailing address

409 E Euclid Ave Ste B
Mount Prospect, IL 60056-1214

Other identifiers 1

IdentifierTypeStateIssuer
195558MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1093954091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 E EUCLID AVE STE B",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600561214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E EUCLID AVE STE B",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600561214",
            "telephone_number": "847-368-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUCLID ADVANCED DENTISTRY, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-13",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SABA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-368-0200"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027311",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021002216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195558",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; 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.