SCM Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027726 Issued in IL

Legal business name

SCM DENTAL PC

Practice address

2435 Glenwood Ave
Joliet, IL 60435-5461

Phone

(815) 725-0260

Fax

(815) 729-2126

NPI assigned

May 29, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Sonal C Mehta, DDSNPI 1679737233

Title

Owner/President

Phone

(815) 725-0260

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Sonal Chandrakant Mehta, DDS

  • Dentist
  • Joliet, IL
  • NPI 1679737233
  NPD (past) Authorized official
• Kersey H Antia, PHD

  • Clinical Psychologist
  • Tinley Park, IL
  • NPI 1710962683
  NPD (past)
• Chandrakant K Mehta, DDS

  • Dentist
  • Joliet, IL
  • NPI 1629151717
  NPD (past)

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1609136373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 GLENWOOD AVE",
            "address_2": "SUITE 225",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355474",
            "telephone_number": "815-725-0260",
            "fax_number": "815-729-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 GLENWOOD AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355461",
            "telephone_number": "815-725-0260",
            "fax_number": "815-729-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCM DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "SONAL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "815-725-0260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421529687",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juline E Schumacher, LCPC
• Jaclyn M Schumann
• Michele Schuster
• Noah Robert Schwind, M.D.
• Emily Schwytzer, PT, DPT
• Nicole Scola, OTR/L
• Alexus Scott
• Margaret Scudder, OTR/L
• Secour Dialysis LLC
• Joel See, M.D.

• General Practice Dentistry in Joliet, IL
• Providers in Joliet, 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 Mar 15, 2017; 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.