Smile on of North Shore, PC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

SMILE ON OF NORTH SHORE, PC

Practice address

707 Lake Cook Rd.
Suite 121
Deerfield, IL 60015

Phone

(224) 282-8939

Fax

(773) 337-4988

NPI assigned

Nov 21, 2018

Organization subpart

No

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

Authorized official

Name

Paul Poncza, DDS. DABDSMNPI 1679652382

Title

Owner

Phone

(224) 282-8939

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul J Poncza, D.D.S.

  • General Practice Dentistry
  • Skokie, IL
  • NPI 1679652382
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542758400000",
    "number": "1891264644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 LAKE COOK RD.",
            "address_2": "SUITE 121",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "60015",
            "telephone_number": "224-282-8939",
            "fax_number": "773-337-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 LAKE COOK RD.",
            "address_2": "SUITE 121",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "60015",
            "telephone_number": "224-282-8939",
            "fax_number": "773-337-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE ON OF NORTH SHORE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A",
        "authorized_official_last_name": "PONCZA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-282-8939",
        "authorized_official_credential": "DDS. DABDSM"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vesna Simic, O.D.
• Michael Joseph Simko
• Nicholas Simon, PHARMD
• Divya Singh-Behl, MD
• Hillary Sluga
• Smith Psychotherapy Associates, S.C.
• Jill Fay Smith, BA
• Robert Joel Smith, LCSW
• Smriti Goel M.D. S.C.
• Social Kids by Rachel

• Customized Equipment (DME) in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Customized Equipment (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.