NPIMap

Affordable Dentures & Implants - Illinois, PLLC

Organization Active NPI Dentist · Bourbonnais, IL

NPI 1629644307 · NPPES record last updated Jun 2, 2021

Key facts

NPI
1629644307
Entity type
Organization (NPI type 2)
Primary specialty
Dentist 122300000X
Legal business name
AFFORDABLE DENTURES & IMPLANTS - ILLINOIS, PLLC
Practice address
1569 N State Route 50
Bourbonnais, IL 60914-4429
Phone
(815) 907-8020
NPI assigned
Jun 2, 2021
Organization subpart
No

Authorized official

Name
Dibyendu Mehta, DDS
Title
Owner
Phone
(815) 907-8020

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Affordable Dentures Implants - Illinois PLLC (6 organizations share this tax ID)

Locations

1569 N State Route 50
Bourbonnais, IL 60914
Phone (815) 907-8020

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193400000X SINGLE SPECIALTY GROUP		 122300000X Yes

Addresses

Primary practice location

1569 N State Route 50
Bourbonnais, IL 60914-4429

Mailing address

1569 N State Route 50
Bourbonnais, IL 60914-4429
Phone (815) 907-8020

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 2, 2021.

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1629644307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 N STATE ROUTE 50",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144429",
            "telephone_number": "815-907-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 N STATE ROUTE 50",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144429",
            "telephone_number": "815-907-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - ILLINOIS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "DIBYENDU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-907-8020",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

All providers in Bourbonnais, IL · Dentist in Illinois

Sources for this page

Verify at the official NPI Registry.