PA DENTAL INCORPORATED (NPI# 1548809858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548809858 |
| Entity Type | Organization |
| Organization Name | PA DENTAL INCORPORATED |
| Practice Address |
630 Milwaukee Ave Ste 130 Glenview IL 60025-5655 |
| Mailing Address |
Po Box 189 Northbrook IL 60065-0189 |
| Practice Telephone | 8477303771 |
| Practice Fax Number | 8477303283 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |
| Authorized Official Name | AJITHA PARUCHURI (OWNER) |
| Authorized Official Telephone | 8477303771 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Blissful Dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013120005 | Pa Dental Incorporated | Dentist | 2605a Grand Ave, Waukegan, IL 60085-2410 | 2007-05-07 |
| Street Address |
630 MILWAUKEE AVE STE 130 |
| City | GLENVIEW |
| State | IL |
| Zip Code | 60025-5655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790287118 | Nl Speech and Language Path LLC | Speech-Language Pathologist | 1315 Sherwood Rd., Glenview, IL 60025 | 2018-03-01 |
| 1982128021 | Quinn Goodwin | Speech-Language Pathologist | 41 Waukegan Rd., Glenview, IL 60025 | 2017-07-31 |
| 1447773684 | Roshni Jaimon | Nurse Practitioner | 616 Meadow Dr, Glenview, IL 60025 | 2017-07-19 |
| 1053840488 | Progressive Behavior Solutions LLC | Behavioral Analyst | 2519 Allison Court, Glenview, IL 60025 | 2017-06-08 |
| 1720529969 | Catherine Marquard | Social Worker | 1949 Robincrest Ln, Glenview, IL 60025 | 2017-03-20 |
| 1073055398 | Imad Dababneh | Optometrist | 4150 Williamsburg Ct. Apt 101, Glenview, IL 60025 | 2016-11-17 |
| 1417400565 | Megan Bowman | Nutritionist | 1332 Waukegan Rd., Glenview, IL 60025 | 2016-07-25 |
| 1548621402 | Integrated Care Servises Corp | In Home Supportive Care | 4001 Amalfi Dr., Glenview, IL 60025 | 2016-03-18 |
| 1003277237 | Caring Nurses, Inc | Home Health | 1701 East Lake Ave, Suite 360, Glenview, IL 60025 | 2016-03-16 |
| 1033570841 | Sumy Johny | Pharmacist | 25 Waukegan Road, Glenview, IL 60025 | 2016-03-08 |
| Find all providers in zip 60025 | ||||
| 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 |
|---|---|---|---|---|
| 1316564784 | Michael A Barth | Dentist | 1735 Wildberry Dr Unit A, Glenview, IL 60025-1741 | 2020-07-01 |
| 1871945246 | Arielle Wulfsohn | Dentist | 2348 Iroquois Dr, Glenview, IL 60026-1034 | 2016-07-08 |
| 1508271438 | Gavin Hayes Green | Dentist | 1001 Waukegan Rd, Glenview, IL 60025-3034 | 2014-06-30 |
| 1184048266 | Anna Organ | Dentist | 917 Tamer Ln, Glenview, IL 60025-3768 | 2014-02-11 |
| 1427498096 | Paulina Erdle | Dentist | 1775 Glenview Rd Ste 217, Glenview, IL 60025-2900 | 2013-06-27 |
| 1730424722 | Lawrence S Hochman | Dentist | 843 Laramie Ave, Glenview, IL 60025-3349 | 2012-12-03 |
| 1740413053 | Michael Richard Cholewa | Dentist | 230 Neva Ave, Glenview, IL 60025-5008 | 2009-09-02 |
| 1023255783 | Joung Eun Song | Dentist | 2640 Patriot Blvd Ste 230, Glenview, IL 60026-8075 | 2009-01-15 |
| 1003067737 | Robert J Hodur | Dentist | 1800 Glenview Rd, Glenview, IL 60025-2910 | 2008-09-30 |
| 1871759423 | David L. Dooley | Dentist | 1775 Glenview Rd Ste 107, Glenview, IL 60025-2943 | 2008-08-04 |
| Find all providers in GLENVIEW | ||||
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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.