NPIMap

Organization Active NPI

Nicolas E Kravanya DMD LLC

  • General Practice Dentistry
  • Carlinville, IL
National Provider Identifier
1255412599
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019018555 Issued in IL
Legal business name
NICOLAS E KRAVANYA DMD LLC
Practice address
204 Oakland Ave
Carlinville, IL 62626
Phone
(217) 854-6505
Fax
(217) 854-6505
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Authorized official

Name
Dr. Nicolas Eric Kravanya, DMDNPI 1548469638
Title
Dentist/Owner
Phone
(217) 854-4741

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 019018555 IL Primary

Addresses

Primary practice location

204 Oakland Ave
Carlinville, IL 62626

Mailing address

204 Oakland Ave
Carlinville, IL 62626
Phone (217) 854-4741

Other practice location 1

1451 E. Union Ave
Litchfield, IL 62056
Phone (217) 324-3245

Other names 1

  • Kravanya & Boente Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

204 Oakland Ave
Carlinville, IL 62626
Phone (217) 854-4741

1451 E Union Ave
Litchfield, IL 62056
Phone (217) 324-3245

Practitioners & affiliated clinicians

Practitioners 4

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1255412599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 OAKLAND AVE",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "62626",
            "telephone_number": "217-854-4741",
            "fax_number": "217-854-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 OAKLAND AVE",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "62626",
            "telephone_number": "217-854-6505",
            "fax_number": "217-854-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 E. Union Ave",
            "address_purpose": "LOCATION",
            "city": "Litchfield",
            "state": "IL",
            "postal_code": "62056",
            "country_code": "US",
            "telephone_number": "217-324-3245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NICOLAS E KRAVANYA DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-23",
        "status": "A",
        "authorized_official_last_name": "KRAVANYA",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "217-854-4741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019018555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kravanya & Boente Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlinville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.