Sparkle Dental Group LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SPARKLE DENTAL GROUP LLC

Doing business as

Dentique - Lemont

Practice address

15543 E 127TH St Ste 103
Lemont, IL 60439-8584

Phone

(630) 243-8300

Fax

(630) 243-9493

NPI assigned

Aug 2, 2024

Organization subpart

Yes

Parent organization

SPARKLE DENTAL GROUP LLCAs reported in NPPES

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

Authorized official

Name

Pradeep Khurana

Title

Owner

Phone

(630) 243-8300

Specialties & licenses 1

Addresses

Other names 1

• Dentique - Lemont Doing business as

Tax ID family

Sparkle Dental Group LLC2 organizations share this tax ID, including this one

Part of

Sparkle Dental Group LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sparkle Dental Group LLC

  • Dentist
  • Downers Grove, IL
  • NPI 1689404824
  NPD tax ID

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1932939170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15543 E 127TH ST STE 103",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604398584",
            "telephone_number": "630-243-8300",
            "fax_number": "630-243-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15543 E 127TH ST STE 103",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604398584",
            "telephone_number": "630-243-8300",
            "fax_number": "630-243-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLE DENTAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARKLE DENTAL GROUP LLC",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "KHURANA",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-243-8300"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentique - Lemont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Smile Design, LTD
• Don A Smith, PHARM D
• Liam Smith
• Mary Ann Smith, M.S.
• Elizabeth Anne Smoczynski, LCSW
• Mark A Spencer, DN
• Jennifer L. Splitt-Krull, DDS
• St Joseph Rehabilitation Services LLC
• Dennis Owen Steinbrenner, R.PH.
• Paul F. Stoetzel, D.C.

• Dentist in Lemont, IL
• Providers in Lemont, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.