NPIMap

Organization Active NPI

Brainard G. Llanes DDS, LTD.

Doing business as Modern Essence Dentistry

  • General Practice Dentistry
  • Roselle, IL
National Provider Identifier
1285966671
Registry record updated Feb 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.025966 Issued in IL
Legal business name
BRAINARD G. LLANES DDS, LTD.
Doing business as
Modern Essence Dentistry
Practice address
818 E Nerge Rd
Roselle, IL 60172-4884
Phone
(630) 582-0878
Fax
(630) 582-0898
NPI assigned
Feb 10, 2010
Last updated
Feb 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2010

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

Authorized official

Name
Dr. Brainard G. Llanes, DDSNPI 1366575375
Title
President
Phone
(312) 953-2953

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 Dentistry 1223G0001X 019.025966 IL Primary

Addresses

Primary practice location

818 E Nerge Rd
Roselle, IL 60172-4884

Mailing address

818 E Nerge Rd
Roselle, IL 60172-4884
Phone (630) 582-0878

Other names 1

  • Modern Essence Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

818 E Nerge Rd
Roselle, IL 60172
Phone (630) 582-0878

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1285966671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 E NERGE RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601724884",
            "telephone_number": "630-582-0878",
            "fax_number": "630-582-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 E NERGE RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601724884",
            "telephone_number": "630-582-0878",
            "fax_number": "630-582-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINARD G. LLANES DDS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-10",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "LLANES",
        "authorized_official_first_name": "BRAINARD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-953-2953",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.025966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Essence Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roselle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.