NPIMap

Organization Active NPI

Angel Smile Dental Care, PC

  • Dentist
  • Mt Prospect, IL
National Provider Identifier
1669880258
Registry record updated Jul 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028276 Issued in IL
Legal business name
ANGEL SMILE DENTAL CARE, PC
Practice address
2352 S Elmhurst Rd
Mt Prospect, IL 60056-5805
Phone
(773) 968-9864
Fax
(847) 979-8370
NPI assigned
Jul 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2014

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

Authorized official

Name
Dr. Vasyl M Baranovsky, DDS
Title
Owner
Phone
(847) 621-2287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019028276 IL Primary

Addresses

Primary practice location

2352 S Elmhurst Rd
Mt Prospect, IL 60056-5805

Mailing address

2352 S Elmhurst Rd
Mt Prospect, IL 60056-5805
Phone (773) 968-9864

National Provider Directory

National Provider Directory

Locations

2352 S Elmhurst Rd
Mt Prospect, IL 60056
Phone (773) 340-2152

Practitioners & affiliated clinicians

Practitioners 1

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": "1406332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406332800000",
    "number": "1669880258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 S ELMHURST RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600565805",
            "telephone_number": "773-968-9864",
            "fax_number": "847-979-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2352 S ELMHURST RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600565805",
            "telephone_number": "773-968-9864",
            "fax_number": "847-979-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL SMILE DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-26",
        "last_updated": "2014-07-26",
        "status": "A",
        "authorized_official_last_name": "BARANOVSKY",
        "authorized_official_first_name": "VASYL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-621-2287",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2014; 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.