Brand New Smile LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BRAND NEW SMILE LLC

Practice address

261 N Randall Rd Ste 102
Lake in the Hills, IL 60156-5999

Phone

(847) 915-3080

NPI assigned

Sep 27, 2021

Organization subpart

No

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

Authorized official

Name

Tim Stirneman, DDS

Title

Owner

Phone

(847) 854-7645

Specialties & licenses 1

Addresses

Other names 1

• Brand New Smile Other name

Locations

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1699446864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N RANDALL RD STE 102",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565999",
            "telephone_number": "847-915-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N RANDALL RD STE 102",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565999",
            "telephone_number": "847-915-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAND NEW SMILE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "STIRNEMAN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-854-7645",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brand New Smile",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Suzanne Claire Bonje, OTR/L
• Tyler James Boutsikakis
• Joshua Larnelle Boyd, LPC
• Molly Boyer, LIMHP
• Magdalyn Brabec
• Bonnie Louise Bremer, M.D.
• Jason Brescia
• Sherry Lynn Bresnahan, D.C.
• Brian L. O'Byrn DDS, Ms, LTD.
• Maxine Magaretta Brown Huffstead, APN -PMHNP-BC

• Dental Clinic/Center in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.