Smiles of Elgin P.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019019439 Issued in IL

Legal business name

SMILES OF ELGIN P.C

Practice address

860 Summit St
Suite 134
Elgin, IL 60120-5145

Phone

(847) 695-3368

Fax

(847) 695-3351

NPI assigned

Dec 28, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Prasad Gonavarum, DDS

Title

Owner

Phone

(847) 695-3368

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Aleksandra M Gwozdz, DDS

  • General Practice Dentistry
  • Elgin, IL
  • NPI 1457483547
  NPD (past)

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1114296712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST",
            "address_2": "SUITE 134",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601205145",
            "telephone_number": "847-695-3368",
            "fax_number": "847-695-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST",
            "address_2": "SUITE 134",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601205145",
            "telephone_number": "847-695-3368",
            "fax_number": "847-695-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES OF ELGIN P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "GONAVARUM",
        "authorized_official_first_name": "PRASAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-695-3368",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019019439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seeten Singha
• Siri Chanthasalo, D.D.S., P.C.
• Steven R Sirin, DDS
• Beatrice Ann Sisson, RN
• SMD Orthodontics
• Danielle Marie Smirat
• Alexander John Smith, DMD
• Brittney Smith, APN
• Diane Smith
• Imelda Smith, PA-C

• 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 Dec 28, 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.