NPIMap

Organization Active NPI

Myorthos Illinois Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Aurora, IL
National Provider Identifier
1780452003
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
MYORTHOS ILLINOIS ORTHODONTICS PC
Practice address
452 N Eola Rd Ste C
Aurora, IL 60502-9110
Phone
(630) 820-1200
NPI assigned
Dec 15, 2023
Organization subpart
Yes
Parent organization
MYORTHOS ILLINOIS ORTHODONTICS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Casey Lonabocker
Title
VP Operations & Strategy
Phone
(617) 535-3364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

452 N Eola Rd Ste C
Aurora, IL 60502-9110

Mailing address

452 N Eola Rd Ste C
Aurora, IL 60502-9110
Phone (630) 820-1200

Other practice location 1

1111 S Washington St Fl 1
Naperville, IL 60540-7953
Phone (630) 961-3810

Other practice location 2

4827 S Route 59 Ste 115
Naperville, IL 60564-8318
Phone (630) 527-6000

Other names 1

  • Pasha Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Myorthos Illinois Orthodontics PC5 organizations share this tax ID, including this one
Part of
Myorthos Illinois Orthodontics PC

Other organizations with this tax ID 4

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

Locations

452 N Eola Rd
Ste C
Aurora, IL 60502
Phone (630) 820-1200

4827 S Route 59
Ste 115
Naperville, IL 60564
Phone (630) 527-6000

1111 S Washington St
Fl 1
Naperville, IL 60540
Phone (630) 961-3810

Practitioners & affiliated clinicians

Practitioners 3

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": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1780452003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 N EOLA RD STE C",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605029110",
            "telephone_number": "630-820-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 N EOLA RD STE C",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605029110",
            "telephone_number": "630-820-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 S Washington St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605407953",
            "country_code": "US",
            "telephone_number": "630-961-3810",
            "fax_number": "630-961-2466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4827 S Route 59 Ste 115",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605648318",
            "country_code": "US",
            "telephone_number": "630-527-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MYORTHOS ILLINOIS ORTHODONTICS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYORTHOS ILLINOIS ORTHODONTICS PC",
        "enumeration_date": "2023-12-15",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "LONABOCKER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "VP OPERATIONS & STRATEGY",
        "authorized_official_telephone_number": "617-535-3364"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pasha Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.