Bansri Shroff, DMD PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BANSRI SHROFF, DMD PC

Doing business as

Radiant Dental

Practice address

899 S Weber Rd
Suite B
Bolingbrook, IL 60490-5488

Phone

(630) 226-1100

Fax

(630) 863-7499

NPI assigned

Aug 9, 2010

Last updated

Aug 9, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bansri Shroff, DMD

Title

Dentist/President

Phone

(630) 226-1100

Specialties & licenses 1

Addresses

Other names 1

• Radiant Dental Doing business as

Locations

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1871808311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 S WEBER RD",
            "address_2": "SUITE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905488",
            "telephone_number": "630-226-1100",
            "fax_number": "630-863-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 S WEBER RD",
            "address_2": "SUITE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905488",
            "telephone_number": "630-226-1100",
            "fax_number": "630-863-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANSRI SHROFF, DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "SHROFF",
        "authorized_official_first_name": "BANSRI",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "630-226-1100",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiant Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Bolingbrook, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.