COUNTRYSIDE DENTAL GROUP, PC (NPI# 1265812507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265812507 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE DENTAL GROUP, PC |
| Practice Address |
6335 Joliet Rd 200 Countryside IL 60525-7427 |
| Mailing Address |
6335 Joliet Rd Ste 200 Countryside IL 60525-3986 |
| Practice Telephone | 7083521830 |
| Mailing Telephone | 7083521830 |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-08-19 |
| Authorized Official Name | DR. LEILA SHAHBANDAR (PRESIDENT) |
| Authorized Official Telephone | 3124982937 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019028019 | IL | Dental Providers |
| Street Address |
6335 JOLIET RD 200 |
| City | COUNTRYSIDE |
| State | IL |
| Zip Code | 60525-7427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265547319 | Nal Annie Walter | Dentist | 6335 Joliet Rd, Suite 200, Countryside, IL 60525-7431 | 2006-08-20 |
| 1922417666 | Nai Annie Walter Dds,pc | Clinic/Center | 6335 Joliet Rd, Suite 200, Countryside, IL 60525-7427 | 2014-08-07 |
| 1285864629 | Leila Shahbandar | Dentist | 6335 Joliet Rd, 200, Countryside, IL 60525-7427 | 2009-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063923837 | Cheryl Buhrke | Speech-Language Pathologist | 1301 W. Cossitt Ave., La Grange, IL 60525 | 2017-10-19 |
| 1881113462 | Karen Aluise | Speech-Language Pathologist | 6818 Joliet Rd. #2, Indian Head Park, IL 60525 | 2017-09-14 |
| 1689126997 | Adriana Digianfilippo | Occupational Therapist | 18 N. Catherine, Lagrange, IL 60525 | 2016-11-03 |
| 1679953582 | Paulina Pinzon | Counselor | 6548 Laurel Avenue, Indian Head Park, IL 60525 | 2015-06-05 |
| 1639446925 | Aarti Parikh | Pharmacist | 6600 S. Willow Springs Rd, Indian Head Park, IL 60525 | 2011-11-30 |
| 1831476795 | Jessica E Feller | Physician Assistant | 6555 South Willow Springs Road, Suite 6, Countryside, IL 60525 | 2011-11-07 |
| 1477833218 | Robyn Lee Frendling | Behavioral Analyst | 9649 W. 55th St, Countryside, IL 60525 | 2011-08-25 |
| 1457630543 | Kerri E Kabela | Physical Therapist | 705 W. Plainfield Rd, Suite 1, Countryside, IL 60525 | 2011-08-08 |
| 1275826984 | G&u Orthopedic, LLC | Durable Medical Equipment & Medical Supplies | 106 W. Calendar Ave., 127, La Grange, IL 60525 | 2011-05-27 |
| 1952609752 | Athletic and Therapeutic Institute of Naperville, LLC | Physical Therapist | 705 W. Plainfield Road, Suite 1, Countryside, IL 60525 | 2011-03-03 |
| Find all providers in zip 60525 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346327889 | Alan M Janusek | Dentist | 5508 S Brainard Ave, Countryside, IL 60525-3571 | 2006-11-01 |
| 1265547319 | Nal Annie Walter | Dentist | 6335 Joliet Rd, Suite 200, Countryside, IL 60525-7431 | 2006-08-20 |
| 1609989003 | Robert Joseph Shanahan | Dentist | 6686 Joliet Rd, Countryside, IL 60525-4575 | 2006-08-17 |
| 1285864629 | Leila Shahbandar | Dentist | 6335 Joliet Rd, 200, Countryside, IL 60525-7427 | 2009-07-20 |
| 1174647291 | Blaine Patrick Cusck | Dentist | 475 W 55th St, Suite 207, Countryside, IL 60525-3564 | 2007-03-16 |
| 1467549824 | Peter S. Hasiakos | Dentist | 475 W 55th St, Suite #110, Countryside, IL 60525-3564 | 2006-10-06 |
| 1992816557 | Heidi A Novack | Dentist | 6686 Joliet Rd, Countryside, IL 60525-4575 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425230 | Sundeep Franklin Dmd & Daiana Capota Dmd Pllc | Dentist | 320 N Mclean Blvd Ste B, Elgin, IL 60123-3220 | 2020-10-20 |
| 1801403555 | Stephanie Elizabeth Miller | Dentist | 2220 Sisters Ave, Naperville, IL 60564-4394 | 2020-09-27 |
| 1417564121 | Gursimran Reen, Dmd LLC | Dentist | 29 S Webster St Ste 108, Naperville, IL 60540-5353 | 2020-09-26 |
| 1285240531 | Summit Dental Center LLC | Dentist | 7710 W 62nd Pl, Summit, IL 60501-1702 | 2020-09-22 |
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1932713583 | Kevin G Reardon | Dentist | 479 S Spring Rd, Elmhurst, IL 60126-3857 | 2020-09-01 |
| 1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
| 1548870884 | Daniel Patrick Jurgens | Dentist | 2 N Country Club Rd Ste 2, Decatur, IL 62521-4174 | 2020-08-02 |
| 1184233934 | Shawna Jade Dudovitz | Dentist | 309 Tamarack Ln, Shiloh, IL 62269-2993 | 2020-07-28 |
| 1417565748 | Robert Hails | Dentist | 3540 N Belt W Ste B, Belleville, IL 62226-5975 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
| City | COUNTRYSIDE |
| Zip Code | 60525 |
Please comment or provide details below to improve the information on COUNTRYSIDE DENTAL GROUP, PC.
| 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.