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Contact Information

ADVANCED ENDODONTICS, PC
103 S. GREENLEAF STREET
SUITE K
GURNEE, IL60031
 Phone: 847-782-0048
 Fax: 847-782-0102
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for ADVANCED ENDODONTICS, PC

NPI Number 1588163364
LBN Legal business name ADVANCED ENDODONTICS, PC
Authorized official JOHN STUPARITZ - (PRESIDENT OWNER DDS)
Entity Organization
Organization subpart 1 No
Enumeration date 02/07/2018
Last updated 02/07/2018 - About 8 years ago
Identifiers
IL License # 019.020999
IL License # 021.001771
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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