Shining Smiles Plainfield Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028115 Issued in IL

Legal business name

SHINING SMILES PLAINFIELD INC

Practice address

13400 S Route 59
Suite 104
Plainfield, IL 60585-5826

Phone

(312) 217-2223

NPI assigned

Aug 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Milad Nourahmadi, D.D.S.

Title

President

Phone

(312) 217-2223

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1376976563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 W FULTON ST",
            "address_2": "UNIT 612",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 S ROUTE 59",
            "address_2": "SUITE 104",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855826",
            "telephone_number": "312-217-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING SMILES PLAINFIELD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-12",
        "last_updated": "2013-08-12",
        "status": "A",
        "authorized_official_last_name": "NOURAHMADI",
        "authorized_official_first_name": "MILAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-217-2223",
        "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": "019028115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Plainfield, IL
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• General Practice Dentistry in Illinois

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