NPIMap

Organization Active NPI

Spark Dental PC

  • Dental Clinic/Center
  • Streamwood, IL
National Provider Identifier
1295424620
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SPARK DENTAL PC
Practice address
1050 S Barrington Rd Ste a
Streamwood, IL 60107-2464
Phone
(630) 672-7877
NPI assigned
May 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Authorized official

Name
Nishu SharmaNPI 1063709186
Title
President
Phone
(630) 672-7877

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1050 S Barrington Rd Ste a
Streamwood, IL 60107-2464

Mailing address

PO Box 597
South Elgin, IL 60177-0597

Other names 1

  • SPARK DENTAL Former legal business name

National Provider Directory

National Provider Directory

Locations

1050 S Barrington Rd
Ste A
Streamwood, IL 60107
Phone (630) 672-7877

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1295424620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601770597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 S BARRINGTON RD STE A",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072464",
            "telephone_number": "630-672-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "NISHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-672-7877"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPARK DENTAL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Streamwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.