Individual provider Active NPI

Emma Tello, DMD

  • Dentist
  • Montgomery, IL
National Provider Identifier
1619871829
Registry record updated Oct 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.037124 Issued in IL
Practice address
20 Boulder Hill Pass
Montgomery, IL 60538-1951
Phone
(630) 896-5013
NPI assigned
Oct 3, 2026
Last updated
Oct 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.037124 IL Primary

Addresses

Primary practice location

20 Boulder Hill Pass
Montgomery, IL 60538-1951

Mailing address

4429 Belmont Rd
Downers Grove, IL 60515-2528
Phone (323) 983-1688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790985600000",
    "number": "1619871829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4429 BELMONT RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152528",
            "telephone_number": "323-983-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BOULDER HILL PASS",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605381951",
            "telephone_number": "630-896-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLO",
        "first_name": "EMMA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-03",
        "last_updated": "2026-10-03",
        "certification_date": "2026-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.037124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.