NPIMap

Organization Active NPI

Prosperritta Dental, PLLC

  • General Practice Dentistry
  • Bensenville, IL
National Provider Identifier
1255090734
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PROSPERRITTA DENTAL, PLLC
Practice address
545 S York Rd Ste 200
Bensenville, IL 60106-3000
Phone
(630) 766-0115
Fax
(630) 766-1164
NPI assigned
Dec 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Shivam S Patel, DDSNPI 1396000956
Title
Owner
Phone
(224) 558-4897

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

545 S York Rd Ste 200
Bensenville, IL 60106-3000

Mailing address

545 S York Rd Ste 200
Bensenville, IL 60106-3000
Phone (630) 766-0115

National Provider Directory

National Provider Directory

Locations

545 S York Rd
Ste 200
Bensenville, IL 60106
Phone (630) 766-0115

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1255090734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 S YORK RD STE 200",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601063000",
            "telephone_number": "630-766-0115",
            "fax_number": "630-766-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 S YORK RD STE 200",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601063000",
            "telephone_number": "630-766-0115",
            "fax_number": "630-766-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERRITTA DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SHIVAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-558-4897",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.