Udelson Elmhurst LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

021001495 Issued in IL

Legal business name

UDELSON ELMHURST LLC

Doing business as

Elmhurst Dentistry for Kids

Practice address

323 N York St
Elmhurst, IL 60126-2319

Phone

(630) 833-1166

NPI assigned

Oct 24, 2017

Last updated

Jul 17, 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

Jerry Udelson, DDSNPI 1013134154

Title

Owner

Phone

(630) 833-1166

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elmhurst Dentistry for Kids Doing business as

Locations

Practitioners 4

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.

• Jerry Udelson, DDS

  • Pediatric Dentistry
  • Forest Park, IL
  • NPI 1013134154
  NPD Authorized official
• Michael Darrell Ewers, D.D.S.

  • Pediatric Dentistry
  • Elmhurst, IL
  • NPI 1437152980
  NPD (past)
• Priyal P Mangrola, DMD

  • Pediatric Dentistry
  • Lake Forest, IL
  • NPI 1023539947
  NPD (past)
• Joshua Woodruff, DMD

  • Pediatric Dentistry
  • Forest Park, IL
  • NPI 1013331644
  NPD (past)

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1245741768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262319",
            "telephone_number": "630-833-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262319",
            "telephone_number": "630-833-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UDELSON ELMHURST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2024-07-17",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "UDELSON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-833-1166",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "021001495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRIC DENTISTRY",
            "identifier": "021001495",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmhurst Dentistry for Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert M Turf, DPM
• Kennedy Arie Turner
• Jana Michelle Tuttle, PT
• Jennifer Raz Tuttle, PT
• Joao Gabriel Ubatuba, M.D.
• Ashler Uebele
• Audra Elise Uhlenhake
• United Dental & Braces Corp (United Dental & Braces)
• Unity Supply Inc
• Unity Supply Inc

• Dental Clinic/Center in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.