NPIMap

Organization Active NPI

Joyful Smiles Pediatric Dentistry of Bradley

  • Pediatric Dentistry
  • Bradley, IL
National Provider Identifier
1417637158
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
JOYFUL SMILES PEDIATRIC DENTISTRY OF BRADLEY
Practice address
840 N Kinzie Ave
Bradley, IL 60915-1231
Phone
(815) 935-5560
NPI assigned
Jul 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Yaa Noel McDonald, DMDNPI 1124331731
Title
President/Pediatric Dentist
Phone
(773) 290-3500

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

840 N Kinzie Ave
Bradley, IL 60915-1231

Mailing address

PO Box 349
Bradley, IL 60915-0349
Phone (815) 935-5560

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1417637158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 349",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609150349",
            "telephone_number": "815-935-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N KINZIE AVE",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609151231",
            "telephone_number": "815-935-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOYFUL SMILES PEDIATRIC DENTISTRY OF BRADLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "YAA",
        "authorized_official_middle_name": "NOEL",
        "authorized_official_title_or_position": "PRESIDENT/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "773-290-3500",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.