MGM19 INC NPI 1215579008

NPI Information

  • NPI: 1215579008
  • Provider Name: MGM19 INC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Doing Business As: MCKNIGHT ORAL, MAXILLOFACIAL AND DENTAL IMPLANT SURGERY
  • Address: 605 COURTYARD DR
    SAINT CHARLES, IL
    ZIP 60174
  • Phone: (630) 377-7077

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NPI Details

MGM19 INC is an oral and maxillofacial surgery dentist in Saint Charles, IL. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. MGM19 INC NPI is 1215579008. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Mcknight Oral, Maxillofacial And Dental Implant Surgery.

The provider's business location address is:

605 COURTYARD DR
SAINT CHARLES, IL
ZIP 60174-463
Phone: (630) 377-7077

The provider's authorized official is Matthew Gregory Mcknight .
The authorized official title is Owner/president and has the following contact phone number (630) 377-7077.

The enumeration date for this NPI number is 10/13/2019 and was last updated on 3/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1021.002827OTHERILLINOISSPECIALIST LICENSE DENTISTRY
2036.144437OTHERILLINOISMEDICAL LICENSE
31518250125OTHERILLINOISNPI
4019.029613OTHERILLINOISDENTAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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