The Traveling Tooth Fairy

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

THE TRAVELING TOOTH FAIRY

Practice address

1212 S. Naper Blvd., Ste. #119/177
Naperville, IL 60540

Phone

(312) 391-3385

NPI assigned

Aug 12, 2024

Last updated

Aug 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeanne BryantNPI 1548091408

Title

General Manager

Phone

(630) 738-1019

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeanne Bryant

  • Dental Hygienist
  • Naperville, IL
  • NPI 1548091408
  NPD Authorized official

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1679304521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 S. NAPER BLVD., STE. #119/177",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60540",
            "telephone_number": "630-738-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 S. NAPER BLVD., STE. #119/177",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60540",
            "telephone_number": "312-391-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TRAVELING TOOTH FAIRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "630-738-1019"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health or Welfare Agency in Naperville, IL
• Providers in Naperville, IL by specialty
• Public Health or Welfare Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.