Organization Active NPI

Smile With US PC

  • General Practice Dentistry
  • Kewanee, IL
National Provider Identifier
1386077436
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019027941 Issued in IL
Legal business name
SMILE WITH US PC
Practice address
529 Tenney St
Kewanee, IL 61443-3746
Phone
(773) 733-6344
NPI assigned
Aug 13, 2013
Last updated
Aug 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Authorized official

Name
Dr. Bogdan Mihai TaranNPI 1477789352
Title
President
Phone
(773) 733-6344

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019027941 IL Primary

Addresses

Primary practice location

529 Tenney St
Kewanee, IL 61443-3746

Mailing address

501 Dodge St
Kewanee, IL 61443-3258
Phone (773) 733-6344

National Provider Directory

National Provider Directory

Locations

529 Tenney St
Kewanee, IL 61443
Phone (309) 853-3684

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": "1376352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1386077436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DODGE ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433258",
            "telephone_number": "773-733-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 TENNEY ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433746",
            "telephone_number": "773-733-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE WITH US PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "TARAN",
        "authorized_official_first_name": "BOGDAN",
        "authorized_official_middle_name": "MIHAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-733-6344",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kewanee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.