NPIMap

Organization Active NPI

Happy Faces Kids & Family Dentistry

  • Dentist
  • Flora, IL
National Provider Identifier
1558730416
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.030203 Issued in IL
Legal business name
HAPPY FACES KIDS & FAMILY DENTISTRY
Practice address
501 N Main St
10
Flora, IL 62839-1405
Phone
(618) 662-2025
NPI assigned
Sep 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Authorized official

Name
Dr. Krishna Gorantla, DDSNPI 1336521004
Title
President
Phone
(812) 229-2675

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019.030203 IL Primary

Addresses

Primary practice location

501 N Main St
10
Flora, IL 62839-1405

Mailing address

501 N Main St
Flora, IL 62839-1405

National Provider Directory

National Provider Directory

Locations

501 N Main St
#10
Flora, IL 62839
Phone (618) 662-2025

501 N Main St
Flora, IL 62839
Phone (618) 403-5040

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": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1558730416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N MAIN ST",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628391405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N MAIN ST",
            "address_2": "10",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628391405",
            "telephone_number": "618-662-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAPPY FACES KIDS & FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "GORANTLA",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-229-2675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.