NPIMap

Organization Active NPI

Clear Smile Center, P.C.

  • Dentist
  • Highland Park, IL
National Provider Identifier
1912318700
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
060011269 Issued in IL
Legal business name
CLEAR SMILE CENTER, P.C.
Practice address
332 Skokie Valley Rd
Highland Park, IL 60035-4415
Phone
(224) 249-9500
NPI assigned
May 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Authorized official

Name
Heekyoung Jo
Title
President
Phone
(847) 476-4050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 060011269 IL Primary

Addresses

Primary practice location

332 Skokie Valley Rd
Highland Park, IL 60035-4415

Mailing address

1146 Oxford Rd
Deerfield, IL 60015-3325

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1912318700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 OXFORD RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 SKOKIE VALLEY RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600354415",
            "telephone_number": "224-249-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR SMILE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-14",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "JO",
        "authorized_official_first_name": "HEEKYOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-476-4050"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "060011269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.