Kokila Avasthi DDS PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

019022366 Issued in IL

Legal business name

KOKILA AVASTHI DDS PC

Practice address

401 S Greenleaf Ave
Ste #3
Park City, IL 60085-5744

Phone

(847) 662-8341

NPI assigned

Oct 12, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Kokila Avasthi, DDS

Title

Owner/Dentist

Phone

(847) 662-8341

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1346790565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S GREENLEAF AVE",
            "address_2": "STE 3",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-662-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S GREENLEAF AVE",
            "address_2": "STE #3",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "600855744",
            "telephone_number": "847-662-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKILA AVASTHI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "AVASTHI",
        "authorized_official_first_name": "KOKILA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "847-662-8341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "019022366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIUAL NPI",
            "identifier": "1114091303",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Park City, IL
• Providers in Park City, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.