NPIMap

Organization Active NPI

Dba Simply Teeth

  • General Practice Dentistry
  • Mount Prospect, IL
National Provider Identifier
1912354531
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019029406 Issued in IL
Legal business name
DBA SIMPLY TEETH
Practice address
905 E Rand Rd
Suite 200
Mt Prospect, IL 60056-2570
Phone
(847) 870-1111
Fax
(847) 749-4789
NPI assigned
May 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Dhaval M Patel, DDS
Title
Dentist
Phone
(847) 870-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019029406 IL Primary

Addresses

Primary practice location

905 E Rand Rd
Suite 200
Mt Prospect, IL 60056-2570

Mailing address

905 E Rand Rd
Suite 200
Mt Prospect, IL 60056-2570
Phone (847) 870-1111

National Provider Directory

National Provider Directory

Locations

905 E Rand Rd
Ste 200
Mt Prospect, IL 60056
Phone (847) 870-1111

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1912354531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 E RAND RD",
            "address_2": "SUITE 200",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562570",
            "telephone_number": "847-870-1111",
            "fax_number": "847-749-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 E RAND RD",
            "address_2": "SUITE 200",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562570",
            "telephone_number": "847-870-1111",
            "fax_number": "847-749-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DBA SIMPLY TEETH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DHAVAL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-870-1111",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.