NPIMap

Organization Active NPI

Dekamore Dental P.C.

  • General Practice Dentistry
  • Delkalb, IL
National Provider Identifier
1730408741
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026938 Issued in IL
Legal business name
DEKAMORE DENTAL P.C.
Practice address
2442 Sycamore Rd
Delkalb, IL 60115
Phone
(815) 748-2666
Fax
(815) 748-3981
NPI assigned
Jun 1, 2010
Last updated
Mar 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Authorized official

Name
Jabal Patel, DMDNPI 1700957321
Title
Owner/President
Phone
(815) 748-2666

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019026938 IL Primary

Addresses

Primary practice location

2442 Sycamore Rd
Delkalb, IL 60115

Mailing address

2158 Randall Rd
Carpentersville, IL 60110
Phone (847) 426-9430

National Provider Directory

National Provider Directory

Locations

2158 Randall Rd
Carpentersville, IL 60110
Phone (847) 426-9430

2442 Sycamore Rd
DeKalb, IL 60115
Phone (815) 748-2666

2563 Sycamore Rd
Unit B
DeKalb, IL 60115

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1730408741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 RANDALL RD",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "60110",
            "telephone_number": "847-426-9430",
            "fax_number": "847-426-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 SYCAMORE RD",
            "city": "DELKALB",
            "state": "IL",
            "postal_code": "60115",
            "telephone_number": "815-748-2666",
            "fax_number": "815-748-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKAMORE DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-01",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JABAL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "815-748-2666",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.