Graceful Smiles Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019.027466 Issued in IL

Legal business name

GRACEFUL SMILES DENTAL

Practice address

615 S Randall Rd Ste 110
Saint Charles, IL 60174-1564

Phone

(847) 414-3560

NPI assigned

Sep 12, 2017

Last updated

Sep 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

George Mathew, DDS

Title

Dentist

Phone

(847) 414-3560

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505174400000",
    "number": "1306365234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 CHANCERY LN",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601103467",
            "telephone_number": "847-414-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S RANDALL RD STE 110",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601741564",
            "telephone_number": "847-414-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL SMILES DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-414-3560",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019.027466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leticia Gonzalez, M.D.
• Yaritza Gonzalez
• Good Mental Health PLLC
• Julie Ann Gorski, MD
• Grace Health & Wellness PLLC
• Bradley T Graff, LPC
• Hoang Gralewski, FNP
• Samantha Grams, PT
• Gray DME Solutions LLC
• Chelsea A Graziano, M.S. CCC-SLP

• Dental Clinic/Center in St Charles, IL
• Providers in St Charles, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.