Crest Dental Care PC

Primary specialty

DentistTaxonomy code 122300000X

License

019027410 Issued in IL

Legal business name

CREST DENTAL CARE PC

Practice address

1354 W Army Trail Rd
Carol Stream, IL 60188-4836

Phone

(630) 830-9000

NPI assigned

May 27, 2016

Organization subpart

No

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

Authorized official

Name

Monil P Shah, DMD

Title

President

Phone

(630) 830-9000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1902254295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1354 W ARMY TRAIL RD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601884836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 W ARMY TRAIL RD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601884836",
            "telephone_number": "630-830-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MONIL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-830-9000",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Corbet, MA, BCBA
• Imee Cordero, OTR
• Sarah Margaret Cosentino, ATC
• Melissa Ann Costner, RDH
• Dale Cress, D.C.
• Crest Dental Group PC
• Crest Dental LLC
• Crestwood Counseling LLC
• Nenita P Cudiamat
• John Rairdon Curphey, MDIV.,M.A.

• Dentist in Carol Stream, IL
• Providers in Carol Stream, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.