NPIMap

Organization Active NPI

Crystal Smiles Dental

  • General Practice Dentistry
  • North Riverside, IL
National Provider Identifier
1104732684
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CRYSTAL SMILES DENTAL
Practice address
8917 W Cermak Rd
North Riverside, IL 60546-1163
Phone
(708) 442-8787
NPI assigned
Aug 24, 2026
Last updated
Aug 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CRYSTAL SMILES DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Authorized official

Name
Dr. Simon A Tadros, DMDNPI 1528742384
Title
Owner
Phone
(708) 307-4908

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

8917 W Cermak Rd
North Riverside, IL 60546-1163

Mailing address

8917 W Cermak Rd
North Riverside, IL 60546-1163

National Provider Directory

National Provider Directory
Tax ID family
Crystal Smiles Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1104732684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8917 W CERMAK RD",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8917 W CERMAK RD",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461163",
            "telephone_number": "708-442-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL SMILES DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRYSTAL SMILES DENTAL",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-23",
        "status": "A",
        "authorized_official_last_name": "TADROS",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-307-4908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Riverside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.