GRACEFUL SMILES DENTAL (NPI# 1306365234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306365234 |
| Entity Type | Organization |
| Organization Name | GRACEFUL SMILES DENTAL |
| Practice Address |
615 S Randall Rd Ste 110 Saint Charles IL 60174-1564 |
| Mailing Address |
3520 Chancery Ln Carpentersville IL 60110-3467 |
| Practice Telephone | 8474143560 |
| Mailing Telephone | 8474143560 |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2017-09-12 |
| Authorized Official Name | GEORGE MATHEW (DENTIST) |
| Authorized Official Telephone | 8474143560 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
019.027466 | IL | Ambulatory Health Care Facilities |
| Street Address |
615 S RANDALL RD STE 110 |
| City | SAINT CHARLES |
| State | IL |
| Zip Code | 60174-1564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306474192 | Halinas Residential Home Care | Registered Nurse | 825 North Fifth Avenue, St. Charles, IL 60174 | 2020-03-29 |
| 1205354503 | Connor Lavallie | Chiropractor | 240 W River Dr, St Charles, IL 60174 | 2017-09-07 |
| 1427579952 | Melanie Elizabeth Long | Counselor | 5n147 Oak Leaf Ct, St Charles, IL 60174 | 2017-07-06 |
| 1255860656 | Hannah Elizabeth Gambrel | Counselor | 12 South 7th Avenue, St. Charles, IL 60174 | 2017-06-08 |
| 1275981490 | Anju Patel | Pharmacist | 2038 Praire St, St. Charles, IL 60174 | 2016-05-27 |
| 1316328529 | Allison Jensen | Dentist | 11 S. 2nd Ave #11, St. Charles, IL 60174 | 2015-06-12 |
| 1225466576 | Chelsea Wright | Social Worker | 522 W Main St Unit 2d, St Charles, IL 60174 | 2013-10-24 |
| 1114261427 | Bryan R. Cichon Dds PC | Dentist | 700 S. Randall Rd., Suite #1, St. Charles, IL 60174 | 2012-11-27 |
| 1124372289 | Stacey Lynn Conner | Developmental Therapist | 910 Manley Rd, St. Charles, IL 60174 | 2012-10-28 |
| 1093070567 | St. Charles Service Corporation | Physical Therapist | 1615 W. Main Street, St. Charles, IL 60174 | 2012-07-10 |
| Find all providers in zip 60174 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023258936 | Elm Dental Care, LLC | Clinic/Center | 3820 Elm St, Saint Charles, MO 63301-4368 | 2009-03-05 |
| 1811182249 | Robert J Schmidt Dds LLC | Clinic/Center | 2043 S Old Highway 94, Saint Charles, MO 63303-3724 | 2007-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629514 | Chicago Pediatric Dentistry and Orthodontics | Clinic/Center | 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 | 2020-11-03 |
| 1437750031 | Secure Dental Xi | Clinic/Center | 1843 W Golf Rd, Schaumburg, IL 60194-1148 | 2020-11-02 |
| 1780283267 | Jenna Gaw, Dds, Pllc | Clinic/Center | 1724 Locust Pl Apt 303, Schaumburg, IL 60173-4239 | 2020-10-26 |
| 1740889344 | Nsp Dental LLC | Clinic/Center | 1900 Hollister Dr Ste 190, Libertyville, IL 60048-5283 | 2020-10-23 |
| 1285232827 | Paul Doodes Dds Phd PC | Clinic/Center | 45 S Park Blvd Ste 190, Glen Ellyn, IL 60137-6282 | 2020-10-15 |
| 1780290676 | Great Smile Dental Pllc | Clinic/Center | 720 Osterman Ave Ste 304, Deerfield, IL 60015-4339 | 2020-09-16 |
| 1669087375 | Naperville Smiles Dental | Clinic/Center | 8 W Gartner Rd Ste 124, Naperville, IL 60540-7549 | 2020-09-09 |
| 1649883364 | Mark J Maly Estate | Clinic/Center | 103 S Main St # Po, Orangeville, IL 61060-9244 | 2020-08-24 |
| 1760094718 | Stoffel and Tomazin Dental Associates, Ltd | Clinic/Center | 5718 W 35th St, Cicero, IL 60804-4222 | 2020-08-20 |
| 1215548771 | Meda Dental II LLC | Clinic/Center | 2735 Hassert Blvd Ste 159, Naperville, IL 60564-5205 | 2020-08-10 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CHARLES |
| Zip Code | 60174 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.