NPIMap

Organization Active NPI

Dental Professionals of Illinois, P.C.

Doing business as Boulevard Place Dental Care

  • General Practice Dentistry
  • Plainfield, IL
National Provider Identifier
1366227241
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Doing business as
Boulevard Place Dental Care
Practice address
16302 S Boulevard PL Unit 102
Plainfield, IL 60586-4403
Phone
(815) 676-3337
Fax
(815) 676-3734
NPI assigned
Aug 29, 2023
Last updated
Aug 29, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Belinda Huerta
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

16302 S Boulevard PL Unit 102
Plainfield, IL 60586-4403

Mailing address

16302 S Boulevard PL Unit 102
Plainfield, IL 60586-4403
Phone (815) 676-3337

Other names 1

  • Boulevard Place Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Illinois PC75 organizations share this tax ID, including this one
Part of
Dental Professionals of Illinois PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

16302 S Boulevard Pl
Unit 102
Plainfield, IL 60586
Phone (815) 676-3337

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1366227241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16302 S BOULEVARD PL UNIT 102",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605864403",
            "telephone_number": "815-676-3337",
            "fax_number": "815-676-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16302 S BOULEVARD PL UNIT 102",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605864403",
            "telephone_number": "815-676-3337",
            "fax_number": "815-676-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF ILLINOIS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF ILLINOIS, P.C.",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "HUERTA",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulevard Place Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.