SUBURBAN FAMILY DENTAL (NPI# 1295978104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295978104 |
| Entity Type | Organization |
| Organization Name | SUBURBAN FAMILY DENTAL |
| Practice Address |
645 W Golf Rd Des Plaines IL 60016-2462 |
| Mailing Address |
645 West Golf Road Des Plaines IL 60016 |
| Practice Telephone | 8476400778 |
| Practice Fax Number | 8476402599 |
| Mailing Telephone | 8476400778 |
| Mailing Fax Number | 8476402599 |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2009-04-08 |
| Authorized Official Name | MARY MILLER (OFFICE MANAGER) |
| Authorized Official Telephone | 8476400778 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
019022514 | IL | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
019016362 | IL | Dental Providers |
| N | 1223P0300X |
Dentist Specialization: Periodontics |
019022485 | IL | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
019016834 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114366234 | Suburban Family Dental | Clinic/Center | 2725 S Milford Rd, Highland, MI 48357 | 2013-06-21 |
| 1629291281 | Suburban Family Dental | Dentist | 646 N French Rd, Suite 8, Amherst, NY 14228-2100 | 2007-04-11 |
| Street Address |
645 W GOLF RD |
| City | DES PLAINES |
| State | IL |
| Zip Code | 60016-2462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194749127 | Marc A Miller | Dentist | 645 W Golf Rd, Des Plaines, IL 60016-2462 | 2006-07-26 |
| 1528076015 | Roman M Dziubyk | Dentist | 645 W Golf Rd, Des Plaines, IL 60016-2462 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043702830 | Professional Healthcare Inc | Family Medicine | 960 Rand Rd Ste 224, Des Plaines, IL 60016 | 2018-06-06 |
| 1407367022 | Vcare Pharmacy Inc | Pharmacy | 380 E Nortwest Hwy, Suite 201, Des Plaines, IL 60016 | 2017-10-23 |
| 1649799610 | George N Hotousiotis | Pharmacist | 10 East Golf Road, Des Plaines, IL 60016 | 2017-09-11 |
| 1619494838 | Abdul M Shamsuddin | Physical Therapist | 2555 Suffield St, Des Plaines, IL 60016 | 2017-08-28 |
| 1063960482 | Rachel Kimbrough | Counselor | 100 N River Road, Des Plaines, IL 60016 | 2016-09-14 |
| 1902250178 | Perfect Storm Chiropractic, LLC | Chiropractor | 565 Concord Ln, Des Plaines, IL 60016 | 2016-04-14 |
| 1255796611 | Nektaria Goudis | Psychologist | 950 Lee Street, Des Plaines, IL 60016 | 2015-12-29 |
| 1831501352 | Gary R. Kuntz | Dentist | 1173 Algonquin Rd., Des Plaines, IL 60016 | 2014-06-02 |
| 1558773754 | Midwest Anesthesia and Pain Specialists, Sc | Pain Medicine | 9700 Golf Rd, Second Floor, Des Plaines, IL 60016 | 2014-05-22 |
| 1508282377 | Maciej Padowski | Emergency Medicine | 9500 Greenwood Dr, Des Plaines, IL 60016 | 2014-03-17 |
| Find all providers in zip 60016 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740284363 | Jeffrey Alan Halpern | Dentist | 701 Lee St, Ste 640, Des Plaines, IL 60016-4548 | 2005-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1215410584 | David Peterson | Dentist | 1619 Brandywine Ln, Dixon, IL 61021-8757 | 2018-09-12 |
| 1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
| 1093232951 | Robert C. Bosack, Dds & Associates, Ltd | Dentist | 16011 108th Ave Ste A, Orland Park, IL 60467-8787 | 2017-08-23 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1770962375 | Eunsu Jung | Dentist | 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 | 2015-05-28 |
| 1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
| 1043607872 | Alissa Nicole Pullos | Dentist | 105 E 1st St Ste 103, Hinsdale, IL 60521 | 2015-04-20 |
| 1538592654 | Matthew Seena Hamedani | Dentist | 3116 Oak Park Ave, Berwyn, IL 60402 | 2013-08-13 |
| 1578907689 | M Timothy Murphy | Dentist | 500 Davis St Ste 509, Evanston, IL 60201-4621 | 2013-04-18 |
| Find all providers with the same taxonomy | ||||
| City | DES PLAINES |
| Zip Code | 60016 |
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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.