Mohit Satish Jethani, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019033792 Issued in IL

Practice address

411 Keokuk St
Lincoln, IL 62656-1726

Phone

(217) 732-8818

NPI assigned

Oct 10, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifetime Dental Care of Illinois, PC

  • General Practice Dentistry
  • Lincoln, IL
  • NPI 1720290638
  NPD (past)
• Dental Dreams LLC

  • General Practice Dentistry
  • Springfield, MA
  • NPI 1245407881
  NPD (past)
• United Smiles, PC

  • General Practice Dentistry
  • Chester, VA
  • NPI 1689022808
  NPD (past)

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1295200798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 E LINCOLN ST APT 2A",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046153",
            "telephone_number": "424-325-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 KEOKUK ST",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626561726",
            "telephone_number": "217-732-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETHANI",
        "first_name": "MOHIT",
        "middle_name": "SATISH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-10",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randi Hope, FNP
• Human Service Center
• Independence Holding Co., LLC
• Linda Sue Irish, P.T.A.
• J a K Enterprises Inc
• Beth M Johnson, DC
• Jani L Jones, LSW
• Ashley J Kaesebier, FNP-BC
• Karen R. Dzekunskas
• Karen R. Dzekunskas

• General Practice Dentistry in Lincoln, IL
• Providers in Lincoln, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2023; 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.