Amber Dental PC
Organization Active NPI Dental Clinic/Center · Wheaton, IL
NPI 1790280758 · NPPES record last updated Nov 6, 2025
Key facts
- NPI
- 1790280758
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- License
- 019019448 (IL)
- Legal business name
- AMBER DENTAL PC
- Practice address
- 319 E Roosevelt Rd
Wheaton, IL 60187-5526 - Phone
- (630) 665-5555
- NPI assigned
- Mar 29, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Michael Koehne, DDS
- Title
- President/Dentist
- Phone
- (630) 665-5555
Practitioners 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190806000617 | IL | DME Supplier - Oral Surgery - Dentist | 6507193133 | Practice locations: Wheaton, IL |
National Provider Directory
Locations
319 E Roosevelt Rd
Wheaton, IL 60187
Phone (630) 665-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 019019448 | IL | Yes |
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
319 E Roosevelt Rd
Wheaton, IL 60187-5526
Mailing address
319 E Roosevelt Rd
Wheaton, IL 60187-5526
Phone (630) 665-5555
Other names
- Amber Dental
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All providers in Wheaton, IL · Dental Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.