NPIMap

Organization Active NPI

Signature Smile Arts, PC

  • General Practice Dentistry
  • Homewood, IL
National Provider Identifier
1619613775
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SIGNATURE SMILE ARTS, PC
Practice address
18114 Gottschalk Ave
Homewood, IL 60430-2208
Phone
(708) 799-5353
NPI assigned
May 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Dr. Alexander Michael Shore, DDSNPI 1407416977
Title
Owner/ President
Phone
(708) 799-5353

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary
Dental Clinic/Center 261QD0000X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

18114 Gottschalk Ave
Homewood, IL 60430-2208

Mailing address

1001 S State St Unit 1401
Chicago, IL 60605-2231
Phone (248) 345-3521

National Provider Directory

National Provider Directory

Locations

18114 Gottschalk Ave
Homewood, IL 60430
Phone (708) 799-5353

Practitioners & affiliated clinicians

Practitioners 3

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": "1652140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1619613775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S STATE ST UNIT 1401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052231",
            "telephone_number": "248-345-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18114 GOTTSCHALK AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302208",
            "telephone_number": "708-799-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE SMILE ARTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-10",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "SHORE",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "708-799-5353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.