Smile Clinique, PC

Primary specialty

DentistTaxonomy code 122300000X

License

19025953 Issued in IL

Legal business name

SMILE CLINIQUE, PC

Practice address

2213 N Il Route 83
Round Lake Beach, IL 60073-4907

Phone

(847) 548-9527

Fax

(847) 548-9637

NPI assigned

Feb 20, 2017

Last updated

Feb 20, 2017By 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. Ritu Malhotra, DDS

Title

Dentist

Phone

(847) 548-9527

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1184163495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 N IL ROUTE 83",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600734907",
            "telephone_number": "847-548-9527",
            "fax_number": "847-548-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 N IL ROUTE 83",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600734907",
            "telephone_number": "847-548-9527",
            "fax_number": "847-548-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE CLINIQUE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "MALHOTRA",
        "authorized_official_first_name": "RITU",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-548-9527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19025953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Round Lake Beach, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.