Confident Smile Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

019026480 Issued in IL

Legal business name

CONFIDENT SMILE DENTAL PC

Practice address

360 Chrysler Drive
Belvidere, IL 61008-6001

Phone

(815) 975-9048

Fax

(815) 975-9056

NPI assigned

Sep 21, 2010

Organization subpart

No

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

Authorized official

Name

Moeen Ikram

Title

President

Phone

(815) 975-9048

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1265740575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 CHRYSLER DRIVE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "61008",
            "telephone_number": "815-975-9048",
            "fax_number": "815-975-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 CHRYSLER DRIVE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610086001",
            "telephone_number": "815-975-9048",
            "fax_number": "815-975-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFIDENT SMILE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "IKRAM",
        "authorized_official_first_name": "MOEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-975-9048"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Choe
• CHW
• City of Belvidere
• Clayton R. Malaker, M.D., S.C.
• Ronald Frederick Conder Sr., DDS
• Michael Gregory Congoran Jr., CCC-SLP/L
• Nicole Connell
• Michael David Corcoran, D.P.M.
• Tanna Coss
• County of Boone

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.