Individual provider Active NPI

Julie Amber Conlin, D.D.S.

  • Dentist
  • Plano, IL
National Provider Identifier
1588915938
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019025575 Issued in IL
Practice address
9 E Main St
Plano, IL 60545-1521
Phone
(630) 552-8900
Fax
(630) 552-0889
NPI assigned
Sep 25, 2012
Last updated
Sep 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019025575 IL Primary

Addresses

Primary practice location

9 E Main St
Plano, IL 60545-1521

Mailing address

9 E Main St
Plano, IL 60545-1521
Phone (630) 552-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160504002769 IL Order and Referring Only - Other (Non-Physician) 7517266091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019025575ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Plano Smiles Dental Center, LTD 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.

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1588915938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 E MAIN ST",
            "city": "PLANO",
            "state": "IL",
            "postal_code": "605451521",
            "telephone_number": "630-552-8900",
            "fax_number": "630-552-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 E MAIN ST",
            "city": "PLANO",
            "state": "IL",
            "postal_code": "605451521",
            "telephone_number": "630-552-8900",
            "fax_number": "630-552-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLIN",
        "first_name": "JULIE",
        "middle_name": "AMBER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, IL

Sources for this page

Verify at the official NPI Registry.