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MY GERIATRIC DENTIST NPI 1366064594


NPI Information

NPI: 1366064594
Provider Name: MY GERIATRIC DENTIST
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
2093 RAND RD
DES PLAINES, IL
ZIP 60016
Phone: (847) 590-1880
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MY GERIATRIC DENTIST is a general practice dentist in Des Plaines, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. MY GERIATRIC DENTIST NPI is 1366064594. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2093 RAND RD
DES PLAINES, IL
ZIP 60016-727
Phone: (847) 590-1880
Fax: (708) 590-0868

The provider's authorized official is Lisa Blumofe .
The authorized official title is Dentist and has the following contact phone number (847) 590-1880.

The enumeration date for this NPI number is 5/11/2020 and was last updated on 5/11/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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