NPIMap

Organization Active NPI

Brian Reardon DDS PC

  • Dentist
  • Elmhurst, IL
National Provider Identifier
1346319126
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019019630 Issued in IL
Legal business name
BRIAN REARDON DDS PC
Practice address
530 S Cherry St
Elmhurst, IL 60126-3900
Phone
(630) 832-8045
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Dr. Brian Reardon, DDSNPI 1215201025
Title
President
Phone
(630) 832-8045

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019019630 IL Primary

Addresses

Primary practice location

530 S Cherry St
Elmhurst, IL 60126-3900

Mailing address

530 S Cherry St
Elmhurst, IL 60126-3900

National Provider Directory

National Provider Directory

Locations

530 S Cherry St
Elmhurst, IL 60126
Phone (630) 832-8045

Practitioners & affiliated clinicians

Practitioners 2

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": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1346319126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S CHERRY ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S CHERRY ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263900",
            "telephone_number": "630-832-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN REARDON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "REARDON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-832-8045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019019630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.