Healthcare Provider Details

I. General information

NPI: 1760306898
Provider Name (Legal Business Name): MICHAEL S. CARRERA DMD MS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 OGDEN AVE STE 104
AURORA IL
60504-7542
US

IV. Provider business mailing address

2124 OGDEN AVE STE 104
AURORA IL
60504-7542
US

V. Phone/Fax

Practice location:
  • Phone: 630-585-6100
  • Fax:
Mailing address:
  • Phone: 630-585-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL S. CARRERA
Title or Position: PRESIDENT
Credential: DMD MS
Phone: 630-470-7828