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Contact Information

A-DENTA CARE SPECIALIST PC
5780 N LINCOLN AVE
CHICAGO, IL60659-4721
 Phone: 773-769-1754
 Fax: 773-769-1370
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Periodontics

1223P0300X
 

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for A-DENTA CARE SPECIALIST PC

NPI # 1417223470
LBN Legal business name A-DENTA CARE SPECIALIST PC
Authorized official JOHN DIMOULIS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/23/2012
Last updated 03/23/2012 - About 14 years ago
Identifiers
IL License # 021001402
IL License # 021002411
IL License # 021002414
IL Other 1962592865 DENTAL PROVIDER
IL Other 136645657 NPI DENTAL PROVIDER
IL Other 1619133345 NPI DENTAL PROVIDER
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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