Siri Chanthasalo, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.025831 Issued in IL

Legal business name

SIRI CHANTHASALO, D.D.S., P.C.

Practice address

3091 W. Route 20
#103
Elgin, IL 60124

Phone

(847) 841-1555

NPI assigned

Oct 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Siri Chanthasalo, D.D.S.NPI 1134286057

Title

President

Phone

(847) 217-7215

Specialties & licenses 1

Addresses

Other names 1

• Providence Family Dental Doing business as

Practitioners 1

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

• Siri Chanthasalo, D.D.S.

  • General Practice Dentistry
  • Elgin, IL
  • NPI 1134286057
  NPD (past) Authorized official

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1114178183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 WESTPORT DR",
            "city": "PINGREE GROVE",
            "state": "IL",
            "postal_code": "601409172",
            "telephone_number": "847-217-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3091 W. ROUTE 20",
            "address_2": "#103",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60124",
            "telephone_number": "847-841-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIRI CHANTHASALO, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "CHANTHASALO",
        "authorized_official_first_name": "SIRI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-217-7215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.025831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Priti Singh, MD
• Raminder P Singh, M.D.
• Sukhvir Kaur Singh, M.D.
• Veerpal Singh, MBBS,M.D.
• Seeten Singha
• Steven R Sirin, DDS
• Beatrice Ann Sisson, RN
• SMD Orthodontics
• Smiles of Elgin P.C
• Danielle Marie Smirat

• General Practice Dentistry in Elgin, IL
• Providers in Elgin, 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 Oct 8, 2008; 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.