Active NPI
Prime Endodontics
- Endodontics
- Tinley Park, IL
National Provider Identifier
1275445835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- Legal business name
- PRIME ENDODONTICS
- Practice address
- 17047 Harlem Ave
Tinley Park, IL 60477-2739 - Phone
- (708) 580-0010
- NPI assigned
- Sep 18, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mahmoud Mona, DMD
- Title
- President
- Phone
- (904) 738-1049
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | Primary |
Addresses
Primary practice location
17047 Harlem Ave
Tinley Park, IL 60477-2739
Mailing address
17047 Harlem Ave
Tinley Park, IL 60477-2739
Phone (708) 580-0010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789689600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789689600000",
"number": "1275445835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17047 HARLEM AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604772739",
"telephone_number": "708-580-0010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17047 HARLEM AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604772739",
"telephone_number": "708-580-0010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIME ENDODONTICS",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-18",
"last_updated": "2026-09-18",
"certification_date": "2026-09-18",
"status": "A",
"authorized_official_last_name": "MONA",
"authorized_official_first_name": "MAHMOUD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "904-738-1049",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
- Precision Diagnostics
- Precision Diagnostics, LLC
- Tammy A. Price, OTR/L, CLVT
- Primary Care Partners LLC
- Primary Healthcare Associates, SC
- Primus Orthopedics SC (Chicago Center for Sports Medicine and Orthopedic Surgery)
- Gregory Lamar Primus, M.D.
- Abigail Marie Prischman
- Professional Counseling Services LTD
- Progressive Radiology of Illinois, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.