Dental Shine II P.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019026154 Issued in IL

Legal business name

DENTAL SHINE II P.C

Doing business as

Apex Dental Care

Practice address

11830 S Route 59
Suite 110
Plainfield, IL 60585-5894

Phone

(815) 609-0000

NPI assigned

Aug 19, 2016

Organization subpart

Yes

Parent organization

DENTAL SHINE II P.C.As reported in NPPES

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

Authorized official

Name

Firas El-Muqdad

Title

President

Phone

(708) 769-1073

Specialties & licenses 1

Addresses

Other names 1

• Apex Dental Care Doing business as

Tax ID family

Dental Shine II PC2 organizations share this tax ID, including this one

Part of

Dental Shine II PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dental Shine II, P, C.

  • Dental Clinic/Center
  • Chicago, IL
  • NPI 1790923274
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Dental Shine II, P, C.

  • Dental Clinic/Center
  • Chicago, IL
  • NPI 1790923274
  NPPES parent name

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1568917508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11830 S ROUTE 59",
            "address_2": "SUITE 110",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855894",
            "telephone_number": "815-609-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11830 S ROUTE 59",
            "address_2": "SUITE 110",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855894",
            "telephone_number": "815-609-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SHINE II P.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL SHINE II P.C.",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "EL-MUQDAD",
        "authorized_official_first_name": "FIRAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-769-1073"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apex Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dennis Dettmann, O.D. S.C.
• Dana Dennis, LPC
• Sara Kaitlyn Denova, LSW
• Dental Associates of Plainfield P.C.
• Dental Professionals of Illinois, P.C.
• Kiranjit K Deol, MD
• Derick Dermatology, PLLC
• Ankit Desai, M.D.
• Samir B Desai, MD
• Deseye Retina LLC

• General Practice Dentistry in Plainfield, IL
• Providers in Plainfield, 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 Aug 19, 2016; 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.