NPIMap

Organization Active NPI

Affordable Dentures & Implants - Illinois, PLLC

Doing business as Affordable Dentures & Implants - Waukegan

  • Dentist
  • Waukegan, IL
National Provider Identifier
1295483535
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
AFFORDABLE DENTURES & IMPLANTS - ILLINOIS, PLLC
Doing business as
Affordable Dentures & Implants - Waukegan
Practice address
3953 Fountain Square PL
Waukegan, IL 60085-6705
Phone
(877) 297-6743
NPI assigned
Mar 15, 2022
Last updated
Mar 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Dibyendu Mehta, DDS
Title
Owner
Phone
(877) 297-6743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

3953 Fountain Square PL
Waukegan, IL 60085-6705

Mailing address

3953 Fountain Square PL
Waukegan, IL 60085-6705
Phone (877) 297-6743

Other names 1

  • Affordable Dentures & Implants - Waukegan Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Affordable Dentures Implants - Illinois PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3953 Fountain Square Pl
Waukegan, IL 60085
Phone (817) 793-8559

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1295483535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3953 FOUNTAIN SQUARE PL",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856705",
            "telephone_number": "877-297-6743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3953 FOUNTAIN SQUARE PL",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856705",
            "telephone_number": "877-297-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - ILLINOIS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "DIBYENDU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-297-6743",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dentures & Implants - Waukegan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.