NPIMap

Organization Active NPI

Candace M Opon DDS

  • Dentist
  • Crystal Lake, IL
National Provider Identifier
1972717247
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019023866 Issued in IL
Legal business name
CANDACE M OPON DDS
Practice address
690 N Route 31
College Hill Professional BLDG
Crystal Lake, IL 60012
Phone
(815) 477-2177
Fax
(815) 477-8671
NPI assigned
May 9, 2007
Last updated
Jun 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Authorized official

Name
Mrs. Candace M Opon, DDSNPI 1053603365
Title
Dentist
Phone
(815) 477-2177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019023866 IL Primary

Addresses

Primary practice location

690 N Route 31
College Hill Professional BLDG
Crystal Lake, IL 60012

Mailing address

690 N Route 31
College Hill Professional BLDG
Crystal Lake, IL 60012
Phone (815) 477-2177

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1972717247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 N ROUTE 31",
            "address_2": "COLLEGE HILL PROFESSIONAL BLDG",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60012",
            "telephone_number": "815-477-2177",
            "fax_number": "815-477-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 N ROUTE 31",
            "address_2": "COLLEGE HILL PROFESSIONAL BLDG",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60012",
            "telephone_number": "815-477-2177",
            "fax_number": "815-477-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDACE M OPON DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "OPON",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "815-477-2177",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.