Athena Dental Group PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.028622 Issued in IL

Legal business name

ATHENA DENTAL GROUP PC

Doing business as

Mount Prospect Smiles

Practice address

724 E Northwest Hwy
Mount Prospect, IL 60056-3442

Phone

(857) 544-2482

NPI assigned

Aug 19, 2016

Last updated

Aug 19, 2016By 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

Dr. Avanti Sanghavi, DDS

Title

Officer

Phone

(857) 544-2482

Specialties & licenses 1

Addresses

Other names 1

• Mount Prospect Smiles Doing business as

Locations

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1689129637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 E NORTHWEST HWY",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563442",
            "telephone_number": "857-544-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 E NORTHWEST HWY",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563442",
            "telephone_number": "857-544-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "SANGHAVI",
        "authorized_official_first_name": "AVANTI",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "857-544-2482",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.028622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Prospect Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Mount Prospect, IL
• Providers in Mount Prospect, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.