MODERN ART OF DENTISTRY, INC (NPI# 1003142100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003142100 |
| Entity Type | Organization |
| Organization Name | MODERN ART OF DENTISTRY, INC |
| Practice Address |
75 S Milwaukee Ave Wheeling IL 60090-3187 |
| Practice Telephone | 8474650800 |
| Practice Fax Number | 8474650053 |
| Mailing Telephone | 8474650800 |
| Mailing Fax Number | 8474650053 |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2009-10-23 |
| Authorized Official Name | DR. KARINA LYON GAVRILOV (OWNER) |
| Authorized Official Telephone | 8474650800 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
0019-024691 | IL | Ambulatory Health Care Facilities |
| Street Address |
75 S MILWAUKEE AVE |
| City | WHEELING |
| State | IL |
| Zip Code | 60090-3187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376641639 | Karina Lyon Gavrilov | Dentist | 75 S Milwaukee Ave, Wheeling, IL 60090-3187 | 2006-09-20 |
| 1558857573 | Erin Ilyse Heffez | Dentist | 75 S Milwaukee Ave, Wheeling, IL 60090 | 2018-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003320318 | Suhani Shail Shah | Pharmacist | Broadway Ave Pharmacy, 151 N 19th Ave, Melrose Park, IL 60090 | 2017-11-22 |
| 1164933479 | Vilija Ball | Psychologist | 307 S Milwaukee Ave Ste 103, Wheeling, IL 60090 | 2017-10-13 |
| 1184143117 | Jeremy Holtmeier | Psychologist | Wheeling School District 21, 999 West Dundee Road, Wheeling, IL 60090 | 2017-09-11 |
| 1326589128 | Nicole Tinetti | Student in an Organized Health Care Education/Training Program | 1410 Marcy Ln, Wheeling, IL 60090 | 2017-03-13 |
| 1881065365 | Melissa Theresa Ballak | Pharmacist | 1400 E Lake-cook Road, Wheeling, IL 60090 | 2015-10-09 |
| 1083031249 | Medtec Healthcare & Private Duty, LLC | Clinic/Center | 43 W Dundee Rd, Wheeling, IL 60090 | 2014-03-26 |
| 1508137464 | Kras Medical S.c. | Dentist | 1532 West Lale Cook Road, Wheeling, IL 60090 | 2012-01-24 |
| 1629351077 | Kedvon Pharmacy Solutions, Inc. | Durable Medical Equipment & Medical Supplies | 56 South Milwaukee Ave., Wheeling, IL 60090 | 2011-09-22 |
| 1992038814 | Ida Neyman | Specialist | 45 Prairie Park Dr., Apt 503, Wheeling, IL 60090 | 2009-09-10 |
| 1396078275 | Funtastic Gymnastic LLC | Physical Therapist | 401 S. Milwaukee Ave, Suite 235, Wheeling, IL 60090 | 2009-09-10 |
| Find all providers in zip 60090 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083841449 | Family Dental Enter Chicago | Clinic/Center | 2710 W Devon Ave. 3rd Floor, Wheeling, IL 60090 | 2009-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629514 | Chicago Pediatric Dentistry and Orthodontics | Clinic/Center | 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 | 2020-11-03 |
| 1437750031 | Secure Dental Xi | Clinic/Center | 1843 W Golf Rd, Schaumburg, IL 60194-1148 | 2020-11-02 |
| 1780283267 | Jenna Gaw, Dds, Pllc | Clinic/Center | 1724 Locust Pl Apt 303, Schaumburg, IL 60173-4239 | 2020-10-26 |
| 1740889344 | Nsp Dental LLC | Clinic/Center | 1900 Hollister Dr Ste 190, Libertyville, IL 60048-5283 | 2020-10-23 |
| 1285232827 | Paul Doodes Dds Phd PC | Clinic/Center | 45 S Park Blvd Ste 190, Glen Ellyn, IL 60137-6282 | 2020-10-15 |
| 1780290676 | Great Smile Dental Pllc | Clinic/Center | 720 Osterman Ave Ste 304, Deerfield, IL 60015-4339 | 2020-09-16 |
| 1669087375 | Naperville Smiles Dental | Clinic/Center | 8 W Gartner Rd Ste 124, Naperville, IL 60540-7549 | 2020-09-09 |
| 1649883364 | Mark J Maly Estate | Clinic/Center | 103 S Main St # Po, Orangeville, IL 61060-9244 | 2020-08-24 |
| 1760094718 | Stoffel and Tomazin Dental Associates, Ltd | Clinic/Center | 5718 W 35th St, Cicero, IL 60804-4222 | 2020-08-20 |
| 1215548771 | Meda Dental II LLC | Clinic/Center | 2735 Hassert Blvd Ste 159, Naperville, IL 60564-5205 | 2020-08-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.