New Millennium Smiles PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027955 Issued in IL

Legal business name

NEW MILLENNIUM SMILES PC

Practice address

323 E Cass St
Joliet, IL 60432-2814

Phone

(708) 543-0795

NPI assigned

Dec 3, 2011

Last updated

Dec 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ahmed Mataria, DDS

Title

Owner

Phone

(708) 543-0795

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1322870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322870400000",
    "number": "1457629578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 E CASS ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322814",
            "telephone_number": "708-543-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E CASS ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322814",
            "telephone_number": "708-543-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MILLENNIUM SMILES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-03",
        "last_updated": "2011-12-03",
        "status": "A",
        "authorized_official_last_name": "MATARIA",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-543-0795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Joliet, IL
• Providers in Joliet, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2011; 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.