Mynt Dental Bolingbrook LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MYNT DENTAL BOLINGBROOK LLC

Practice address

231 N Bolingbrook Dr Ste a
Bolingbrook, IL 60440-1960

Phone

(312) 999-9993

NPI assigned

May 23, 2021

Last updated

Jun 16, 2021By 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. Sasan Molavi, DDSNPI 1467680504

Title

President / Sole Member

Phone

(630) 381-8281

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Sasan Molavi, D.D.S.

  • Dentist
  • Mount Pleasant, WI
  • NPI 1467680504
  NPD Authorized official
• Melissa Camargo, DMD

  • Dentist
  • Bolingbrook, IL
  • NPI 1265171623
  NPD

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

{
    "created_epoch": "1621728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1255906244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 MANNHEIM RD",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601312219",
            "telephone_number": "630-381-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N BOLINGBROOK DR STE A",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401960",
            "telephone_number": "312-999-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYNT DENTAL BOLINGBROOK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-23",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "MOLAVI",
        "authorized_official_first_name": "SASAN",
        "authorized_official_title_or_position": "PRESIDENT / SOLE MEMBER",
        "authorized_official_telephone_number": "630-381-8281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandeep Mudhar, MA, CRC, LCPC
• Raymond B Muehling, DDS
• Jessica Munoz, FNP-BC
• Jo Ann Murphy
• Myeyedr Optometry of Illinois, LLC (MyEyeDr.)
• Francis Sangyoon Nahm, DDS
• Sneha Bakulesh Naik, D.D.S
• Naperbrook Medical Center
• Naperville Medical Group Corporation
• Nathan R. Fisher, D.C., S.C. (Achieve Health and Wellness)

• Dentist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.