NPIMap

Organization Active NPI

Renew Orthodontics

  • Dental Clinic/Center
  • Dekalb, IL
National Provider Identifier
1679806194
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019024635 Issued in IL
Legal business name
RENEW ORTHODONTICS
Practice address
2335 Sycamore Rd
Dekalb, IL 60115-2007
Phone
(815) 756-5200
Fax
(815) 756-5567
NPI assigned
Sep 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Authorized official

Name
Dr. Daryl Ashbeck, DDS MS
Title
Orthodontist
Phone
(815) 756-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019024635 IL Primary

Addresses

Primary practice location

2335 Sycamore Rd
Dekalb, IL 60115-2007

Mailing address

2335 Sycamore Rd
Dekalb, IL 60115-2007
Phone (815) 756-5200

National Provider Directory

National Provider Directory
Tax ID family
Renew Orthodontics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1679806194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 SYCAMORE RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152007",
            "telephone_number": "815-756-5200",
            "fax_number": "815-756-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 SYCAMORE RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152007",
            "telephone_number": "815-756-5200",
            "fax_number": "815-756-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "ASHBECK",
        "authorized_official_first_name": "DARYL",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "815-756-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019024635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.