Smile Experts Dental Associates

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

019028573 Issued in IL

Legal business name

SMILE EXPERTS DENTAL ASSOCIATES

Practice address

1515 W Walnut St
Jacksonville, IL 62650-1150

Phone

(217) 245-1190

Fax

(217) 291-0401

NPI assigned

Mar 6, 2014

Last updated

Mar 6, 2014By 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

Dr. Sheetal Sharma, D.D.S.

Title

Doctor

Phone

(630) 901-7784

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1164848750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501150",
            "telephone_number": "217-245-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501150",
            "telephone_number": "217-245-1190",
            "fax_number": "217-291-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE EXPERTS DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "SHEETAL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "630-901-7784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "019028573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Simpson, MD
• Siu Physicians & Surgeons, Inc
• Denise L Skinner, LCPC
• Michael Scott Slinkard, COTA/L
• Smalltown Dental Jacksonville PLLC
• Callie Soer, DMD
• Julia Anne Speakman, LCSW
• Devin Scott Spears, M.S., A.T.,C.
• Misty Dawn Spencer
• Springfield Clinic Jacksonville Outreach Lab

• Exclusive Provider Organization in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Exclusive Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.