NPIMap

Organization Active NPI

Affordable Dentures & Implants - Illinois, PLLC

  • Dentist
  • Springfield, IL
National Provider Identifier
1649846320
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
AFFORDABLE DENTURES & IMPLANTS - ILLINOIS, PLLC
Practice address
3455 Freedom Dr
Springfield, IL 62704-6517
Phone
(217) 606-0878
NPI assigned
Jun 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Authorized official

Name
Dibyendu Mehta, DDS
Title
Owner
Phone
(217) 606-0878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

3455 Freedom Dr
Springfield, IL 62704-6517

Mailing address

3455 Freedom Dr
Springfield, IL 62704-6517
Phone (217) 606-0878

National Provider Directory

National Provider Directory
Tax ID family
Affordable Dentures Implants - Illinois PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

3455 Freedom Dr
Springfield, IL 62704
Phone (217) 606-0878

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1649846320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 FREEDOM DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046517",
            "telephone_number": "217-606-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 FREEDOM DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046517",
            "telephone_number": "217-606-0878"
        }
    ],
    "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": "217-606-0878",
        "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 Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.