Organization Active NPI

Mi Dental PC

  • Dentist
  • Mt Prospect, IL
National Provider Identifier
1689170318
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028417 Issued in IL
Legal business name
MI DENTAL PC
Practice address
1006 S Elmhurst Rd
Mt Prospect, IL 60056-4240
Phone
(646) 761-5224
NPI assigned
Apr 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Authorized official

Name
Dr. Hyun Min Kim, DDSNPI 1285946749
Title
Dentist
Phone
(646) 761-5224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019028417 IL Primary
Dental Clinic/Center 261QD0000X 019028417 IL

Addresses

Primary practice location

1006 S Elmhurst Rd
Mt Prospect, IL 60056-4240

Mailing address

39 Orrington CT
Schaumburg, IL 60173-2116
Phone (646) 761-5224

National Provider Directory

National Provider Directory

Locations

1006 S Elmhurst Rd
Mt Prospect, IL 60056
Phone (646) 761-5224

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": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522800000000",
    "number": "1689170318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 ORRINGTON CT",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601732116",
            "telephone_number": "646-761-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 S ELMHURST RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600564240",
            "telephone_number": "646-761-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-04",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HYUN",
        "authorized_official_middle_name": "MIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "646-761-5224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028417",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019028417",
            "primary": false
        }
    ],
    "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 Apr 4, 2018; 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.