Chester Smile Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019022619 Issued in IL

Legal business name

CHESTER SMILE CENTER

Practice address

1101 Opdyke St
Chester, IL 62233-2004

Phone

(618) 826-4440

Fax

(618) 826-5799

NPI assigned

Jul 8, 2010

Last updated

Jul 8, 2010By 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

Dr. Michael Peter Holub, D.D.S.

Title

Doctor

Phone

(618) 826-4440

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278547200000",
    "number": "1346552247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 OPDYKE ST",
            "city": "CHESTER",
            "state": "IL",
            "postal_code": "622332004",
            "telephone_number": "618-826-4440",
            "fax_number": "618-826-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OPDYKE ST",
            "city": "CHESTER",
            "state": "IL",
            "postal_code": "622332004",
            "telephone_number": "618-826-4440",
            "fax_number": "618-826-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTER SMILE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "HOLUB",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "618-826-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chester Family Dental PLLC
• Chester Medical Group LLC
• Chester Medical Group, LLC (Chester Clinic)
• Chester Mental Health Center
• Chester Rehabilitation and Nursing Center, LLC
• Renee Cissell, LSW, QMHP
• Douglas Scott Cockrell, PHARMD, RPH
• Comwell
• Comwell
• Comwell

• General Practice Dentistry in Chester, IL
• Providers in Chester, 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 Jul 8, 2010; 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.