NPIMap

Organization Active NPI

Zarasmita DMD LLC

  • Dentist
  • Crystal Lake, IL
National Provider Identifier
1982058848
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019029358 Issued in IL
Legal business name
ZARASMITA DMD LLC
Practice address
1560 Carlemont Dr
Crystal Lake, IL 60014-2740
Phone
(630) 656-2213
Fax
(779) 220-4972
NPI assigned
Apr 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Authorized official

Name
Dr. Brijesh Patel, DMDNPI 1902257322
Title
Owner
Phone
(630) 656-2213

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019029358 IL Primary

Addresses

Primary practice location

1560 Carlemont Dr
Crystal Lake, IL 60014-2740

Mailing address

1560 Carlemont Dr
Crystal Lake, IL 60014-2740
Phone (630) 656-2213

Other identifiers 1

IdentifierTypeStateIssuer
019029358MedicaidIL

Other names 1

  • CRYSTAL FAMILY DENTAL CARE Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1982058848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 CARLEMONT DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142740",
            "telephone_number": "630-656-2213",
            "fax_number": "779-220-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 CARLEMONT DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142740",
            "telephone_number": "630-656-2213",
            "fax_number": "779-220-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZARASMITA DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "BRIJESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-656-2213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019029358",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRYSTAL FAMILY DENTAL CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CRYSTAL FAMILY DENTAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 23, 2019; 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.