ILLINI SMILES DENTAL CARE PC (NPI# 1568841344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568841344 |
| Entity Type | Organization |
| Organization Name | ILLINI SMILES DENTAL CARE PC |
| Practice Address |
125 W Main St Urbana IL 61801-2714 |
| Practice Telephone | 2176071292 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |
| Authorized Official Name | YUDONG XU (PRESIDENT) |
| Authorized Official Telephone | 2176071292 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019026810 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205245693 | Illini Smiles Dental Care PC | Dentist | 201 W Springfield Ave Ste 506, Champaign, IL 61820-6383 | 2014-08-11 |
| 1891245957 | Illini Smiles Dental Care PC | Dentist | 303 W Springfield Ave, Champaign, IL 61820-4817 | 2016-10-12 |
| Street Address |
125 W MAIN ST |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083829782 | Richard David Dietz | Dentist | 314 Patrick Ave, Urbana, OH 43078-2339 | 2007-05-14 |
| 1063583367 | Robert Bruce Sinclair | Dentist | 404 W Green St, Urbana, IL 61801-3267 | 2006-11-10 |
| 1376612929 | Andrew Zamora | Dentist | 1866 E Us Highway 36, Urbana, OH 43078-9600 | 2006-11-07 |
| 1972516250 | Mack Wright | Dentist | 1028 E Us Highway 36, Urbana, OH 43078-9007 | 2006-08-15 |
| 1528683851 | Renee Seungwon Lee | Dentist | 1812 Philo Rd, Urbana, IL 61802-6016 | 2020-06-12 |
| 1629615794 | Limazwick-urbana LLC | Dentist | 139 Patrick Ave, Urbana, OH 43078-2123 | 2019-12-07 |
| 1588194328 | Andrew Evans | Dentist | 611 W Park St, Urbana, IL 61801-2529 | 2017-06-14 |
| 1356780241 | Joseph Yong | Dentist | 1866 E Us Highway 36, Urbana, OH 43078-9600 | 2013-06-24 |
| 1912295700 | Justin Taylor Beck | Dentist | 848 Scioto St, Urbana, OH 43078-2255 | 2011-07-14 |
| 1316175458 | Cole Anderson | Dentist | 602 W University Ave, Urbana, IL 61801-2530 | 2009-06-28 |
| Find all providers in URBANA | ||||
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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.