Organization Active NPI

United Dental & Braces Corp

  • Dentist
  • Elmhurst, IL
National Provider Identifier
1790592376
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
UNITED DENTAL & BRACES CORP
Doing business as
United Dental & Braces
Practice address
585 N York St
Elmhurst, IL 60126-1903
Phone
(773) 499-9385
NPI assigned
Dec 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Jermin M Joseph, DMDNPI 1811681190
Title
Owner/Dentist
Phone
(773) 499-9385

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

585 N York St
Elmhurst, IL 60126-1903

Mailing address

585 N York St
Elmhurst, IL 60126-1903
Phone (773) 499-9385

Other names 1

  • United Dental & Braces Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250516000719 IL Part B Supplier - Clinic/Group Practice 6002334794 Receives reassigned benefits from 1 practitioner
Practice locations: Elmhurst, IL

National Provider Directory

National Provider Directory

Locations

585 N York St
Elmhurst, IL 60126
Phone (773) 499-9385

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": "1734393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1790592376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261903",
            "telephone_number": "773-499-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261903",
            "telephone_number": "773-499-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DENTAL & BRACES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-17",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "JERMIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "773-499-9385",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Dental & Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.