Individual provider Active NPI

Kevin G Reardon, DDS

  • General Practice Dentistry
  • Elmhurst, IL
National Provider Identifier
1932713583
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-032876 Issued in IL
Practice address
479 S Spring Rd
Elmhurst, IL 60126-3857
Phone
(630) 834-1218
Fax
(630) 834-1065
NPI assigned
Sep 1, 2020
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-032876 IL Primary

Addresses

Primary practice location

479 S Spring Rd
Elmhurst, IL 60126-3857

Mailing address

479 S Spring Rd
Elmhurst, IL 60126-3857
Phone (630) 834-1218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019-032876ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin Reardon DDS PLLC CurrentSince Sep 6, 2020 Accepting new patients

Locations

479 S Spring Rd
Elmhurst, IL 60126
Phone (630) 620-6827

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1932713583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 S SPRING RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263857",
            "telephone_number": "630-834-1218",
            "fax_number": "630-834-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 S SPRING RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263857",
            "telephone_number": "630-834-1218",
            "fax_number": "630-834-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "KEVIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-01",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-032876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.