Active NPI
Tejpalsinh Jadeja
- Dentist
- Champaign, IL
National Provider Identifier
1457918716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019032089
- Practice address
- 1905 Convenience PL Ste a
Champaign, IL 61820-8927 - Phone
- (217) 355-5165
- NPI assigned
- May 22, 2019
- Last updated
- May 22, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019032089 | IL | Primary |
Addresses
Primary practice location
1905 Convenience PL Ste a
Champaign, IL 61820-8927
Mailing address
1905 Convenience PL Ste a
Champaign, IL 61820-8927
Phone (217) 355-5165
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019032089 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Professionals of Illinois, P.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Creative Smiles Dental Care
- General Practice Dentistry
- Champaign, IL
- NPI 1114149473
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558483200000",
"number": "1457918716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 CONVENIENCE PL STE A",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618208927",
"telephone_number": "217-355-5165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 CONVENIENCE PL STE A",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618208927",
"telephone_number": "217-355-5165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JADEJA",
"first_name": "TEJPALSINH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-22",
"last_updated": "2019-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019032089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.