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Contact Information

ISMILE DENTAL
4953 WEST FULLERTON AVE
CHICAGO, IL60639
 Phone: 773-887-3244
 Fax: 773-897-6697
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ISMILE DENTAL

NPI Number 1013464593
LBN Legal business name ISMILE DENTAL
Authorized official YESENIA DELGADO - (GENERAL MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/01/2016
Last updated 09/01/2016 - About 10 years ago
Identifiers
IL License # 019-027782
IL Medicaid 1437149622
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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