Organization Active NPI

KMG Dental Services, P.C.

Doing business as Handcrafted Smiles AH

  • General Practice Dentistry
  • Arlington Heights, IL
National Provider Identifier
1851960728
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KMG DENTAL SERVICES, P.C.
Doing business as
Handcrafted Smiles AH
Practice address
2101 S Arlington Heights Rd Ste 117
Arlington Heights, IL 60005-4197
Phone
(847) 357-3899
NPI assigned
Jun 23, 2021
Last updated
Jul 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Authorized official

Name
Dr. Kenny Matee Gomolplitinant, DMDNPI 1184008799
Title
President
Phone
(847) 357-3899

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 Primary

Addresses

Primary practice location

2101 S Arlington Heights Rd Ste 117
Arlington Heights, IL 60005-4197

Mailing address

1610 W Fullerton Ave Unit 203
Chicago, IL 60614-9048
Phone (818) 983-5066

Other names 1

  • Handcrafted Smiles AH Doing business as

National Provider Directory

National Provider Directory

Locations

2101 S Arlington Heights Rd
Ste 117
Arlington Heights, IL 60005
Phone (847) 357-3899

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1851960728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 W FULLERTON AVE UNIT 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606149048",
            "telephone_number": "818-983-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S ARLINGTON HEIGHTS RD STE 117",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054197",
            "telephone_number": "847-357-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMG DENTAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "GOMOLPLITINANT",
        "authorized_official_first_name": "KENNY",
        "authorized_official_middle_name": "MATEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-357-3899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Handcrafted Smiles AH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Handcrafted Smiles AH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.