NPIMap

Organization Active NPI

Smile Creations

  • Dentist
  • Elk Grove Village, IL
National Provider Identifier
1609100775
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-026102 Issued in IL
Legal business name
SMILE CREATIONS
Practice address
1100 Nerge Rd Ste 209
Elk Grove Village, IL 60007-3259
Phone
(847) 891-6600
NPI assigned
Sep 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Authorized official

Name
Dr. Marvin Amayun, DMDNPI 1942212782
Title
Owner
Phone
(630) 687-2974

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019-026102 IL Primary

Addresses

Primary practice location

1100 Nerge Rd Ste 209
Elk Grove Village, IL 60007-3259

Mailing address

1100 Nerge Rd Ste 209
Elk Grove Village, IL 60007-3259
Phone (847) 891-6600

Other names 1

  • Smile Creations Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1100 Nerge Rd
Ste 209
Elk Grove Village, IL 60007
Phone (847) 891-6600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1609100775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NERGE RD STE 209",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073259",
            "telephone_number": "847-891-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NERGE RD STE 209",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073259",
            "telephone_number": "847-891-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE CREATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "AMAYUN",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-687-2974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-026102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Creations Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.