NPIMap

Organization Active NPI

Star Smiles Orthodontics and Pediatric Dentistry

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bloomingdale, IL
National Provider Identifier
1356683536
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
019028920 Issued in IL
Legal business name
STAR SMILES ORTHODONTICS AND PEDIATRIC DENTISTRY
Doing business as
Star Smiles Orthodontics and Pediatric Dentistry
Practice address
148 E Lake St
Unit C
Bloomingdale, IL 60108-1182
Phone
(630) 980-8800
NPI assigned
Mar 26, 2013
Last updated
Oct 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Authorized official

Name
Andre JhamNPI 1750600144
Title
DDS
Phone
(630) 980-8800

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 019028919 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019028920 IL Primary

Addresses

Primary practice location

148 E Lake St
Unit C
Bloomingdale, IL 60108-1182

Mailing address

148 E Lake St
Unit C
Bloomingdale, IL 60108-1182
Phone (630) 980-8800

Other names 1

  • Star Smiles Orthodontics and Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Star Smiles Orthodontics and Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

148 E Lake St
Ste C
Bloomingdale, IL 60108
Phone (512) 354-5852

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1356683536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 E LAKE ST",
            "address_2": "UNIT C",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081182",
            "telephone_number": "630-980-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 E LAKE ST",
            "address_2": "UNIT C",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081182",
            "telephone_number": "630-980-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR SMILES ORTHODONTICS AND PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "JHAM",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "630-980-8800"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019028919",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019028920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Star Smiles Orthodontics and Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.