NPIMap

Organization Active NPI

Illini Smiles Dental Care P.C.

  • General Practice Dentistry
  • Urbana, IL
National Provider Identifier
1972492882
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ILLINI SMILES DENTAL CARE P.C.
Practice address
204 W University Ave
Urbana, IL 61801-1741
Phone
(217) 607-1292
NPI assigned
Jul 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Authorized official

Name
Yudong Xu
Title
Ceo
Phone
(217) 892-8868

Specialties & licenses 1

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

Addresses

Primary practice location

204 W University Ave
Urbana, IL 61801-1741

Mailing address

204 W University Ave
Urbana, IL 61801-1741

National Provider Directory

National Provider Directory
Tax ID family
Illini Smiles Dental Care PC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

204 W University Ave
Urbana, IL 61801
Phone (217) 383-3202

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1972492882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W UNIVERSITY AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618011741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W UNIVERSITY AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618011741",
            "telephone_number": "217-607-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINI SMILES DENTAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "XU",
        "authorized_official_first_name": "YUDONG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-892-8868"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.