- Practice location
- 5780 N Lincoln Ave, Chicago, IL 60659-4721
- Phone
- 773-769-1754
- Fax
- 773-769-1370
- Last updated
- March 23, 2012
A-Denta Care Specialist PC is a healthcare organization based in Chicago, IL. A-Denta Care Specialist PC practices in Chicago, IL. The NPI Number for A-Denta Care Specialist PC is 1417223470 and holds a License No. 021002414 (IL). The current practice location address for A-Denta Care Specialist PC is 5780 N Lincoln Ave, Chicago, IL 60659-4721 and can be reached out via phone at 773-769-1754 and via fax at 773-769-1370.
Provider Profile Details
- NPI Number
- 1417223470
- Provider Name
- A-Denta Care Specialist PC
- Provider Entity Type
- Organization
- Address
- 5780 N Lincoln Ave, Chicago, IL 60659-4721
- Phone Number
- 773-769-1754
- Fax Number
- 773-769-1370
- Primary Taxonomy
- Dentist, Periodontics · 1223P0300X
- Organization Subpart
- No
- Authorized Official
- Dr. John Dimoulis, DDS MS · Owner · 773-769-1754
- Provider Enumeration Date
- March 23, 2012
- Last Update Date
- March 23, 2012
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 5780 N Lincoln Ave
Chicago, IL 60659-4721 - City
- Chicago
- State
- Illinois
- Zip
- 60659-4721
- Phone Number
- 773-769-1754
- Fax Number
- 773-769-1370
Provider Business Mailing Address Details
- Address
- 5780 N Lincoln Ave
Chicago, IL 60659-4721 - City
- Chicago
- State
- IL
- Zip
- 60659-4721
- Phone Number
- 773-769-1754
- Fax Number
- 773-769-1370
License Information
- License Number (1)
- 021002414
- License State (1)
- IL
- Taxonomy (1)
- Dentist, Endodontics · 1223E0200X
- License Number (2)
- 021002411
- License State (2)
- IL
- Taxonomy (2)
- Dentist, Endodontics · 1223E0200X
- License Number (3)
- 021001402
- License State (3)
- IL
- Taxonomy (3)
- Dentist, Periodontics · 1223P0300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of A-Denta Care Specialist PC?
The NPI number of A-Denta Care Specialist PC is 1417223470. It was assigned on March 23, 2012 and is currently active in the NPPES registry.
What is the specialty of A-Denta Care Specialist PC?
A-Denta Care Specialist PC is registered under the primary taxonomy Dentist, Periodontics (code 1223P0300X), licensed in IL under license number 021002414.
Where does A-Denta Care Specialist PC practice?
The practice location is 5780 N Lincoln Ave, Chicago, IL 60659-4721. The office can be reached at 773-769-1754 (phone) or 773-769-1370 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1417223470 directly on the NPPES registry website.