Paul Anast Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PAUL ANAST DENTAL PLLC

Doing business as

Southland Smiles

Practice address

19815 Governors Hwy Ste 7
Flossmoor, IL 60422-4388

Phone

(708) 799-7800

Fax

(708) 799-4864

NPI assigned

Jul 30, 2024

Last updated

Jul 30, 2024By 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

Ms. Kimberly M Cervantes

Title

Manager

Phone

(708) 799-7800

Specialties & licenses 1

Addresses

Other names 1

• Southland Smiles Doing business as

Locations

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.

• Paul Theodore Anast, DMD

  • Dentist
  • Dolton, IL
  • NPI 1700031127
  NPD
• Richard J. Mantoan, DDS

  • General Practice Dentistry
  • Flossmoor, IL
  • NPI 1740283605
  NPD (past)

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1144059940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19815 GOVERNORS HWY STE 7",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604224388",
            "telephone_number": "708-799-7800",
            "fax_number": "708-799-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19815 GOVERNORS HWY STE 7",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604224388",
            "telephone_number": "708-799-7800",
            "fax_number": "708-799-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL ANAST DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "CERVANTES",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-799-7800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southland Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Urshala Palmer
• Melissa Parram
• Amit D Patel, MD
• Binal Patel
• Deep Patel, MD
• Lynne Diane Pavlatos, P.T.
• Peaceful Haven Assisted Living, LLC
• Michael R Peck, M.D.
• Performace Dental Care Il PC
• Performance Dental Care (7-7 Dental of Flossmoor)

• General Practice Dentistry in Flossmoor, IL
• Providers in Flossmoor, 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 Jul 30, 2024; 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.