PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC


Address: 1s224 Summit Ave, Suite 205, Oakbrook Terrace, IL 60181-3983
Phone: 6306273930

PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC (NPI# 1811036718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811036718
Entity Type Organization
Organization Name PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC
Other Organization Name PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LTD
Practice Address 1s224 Summit Ave
Suite 205
Oakbrook Terrace
IL 60181-3983
Practice Telephone 6306273930
Practice Fax Number 6306272148
Mailing Telephone 6306273930
Mailing Fax Number 6306272148
Enumeration Date 2007-02-06
Last Update Date 2016-12-16
Authorized Official Name GEORGE A MANDELARIS (OWNER PERIODONTIST)
Authorized Official Telephone 6306273930
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 1223P0300X Dentist
Specialization: Periodontics
019030200 IL Dental Providers
N 1223P0300X Dentist
Specialization: Periodontics
019024971 IL Dental Providers
N 1223P0300X Dentist
Specialization: Periodontics
019014972 IL Dental Providers
Y 261QD0000X Clinic/Center
Specialization: Dental
060-003629 IL Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Periodontal Medicine and Surgical Specialists, LTD Former Legal Business Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1386098390 Periodontal Medicine and Surgical Specialists, LLC Clinic/Center 1009 W Webster Ave, Chicago, IL 60614-3502 2016-04-15
1588703490 Periodontal Medicine and Surgical Specialists, LLC Dentist 1875 Dempster St, Suite 250, Park Ridge, IL 60068-1186 2007-02-06

Office Location

Street Address 1S224 SUMMIT AVE
SUITE 205
City OAKBROOK TERRACE
State IL
Zip Code 60181-3983

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174519862 Kamal N. Ibrahim Orthopaedic Surgery 1s224 Summit Ave, Suite 203, Oakbrook Terrace, IL 60181-3983 2005-09-27
1194076802 Caitlin Marie Flicek Speech-Language Pathologist 1s224 Summit Ave, Suite 101, Oakbrook Terrace, IL 60181-3983 2012-09-21
1215291901 Bradley S Degroot Dentist 1s224 Summit Ave, #205, Oakbrook Terrace, IL 60181-3983 2012-06-27
1619237872 Soft Landing Interventions Community/Behavioral Health 1s224 Summit Ave, Suite 310, Oakbrook Terrace, IL 60181-3983 2012-05-22
1275892333 Soft Landing Interventions Clinic/Center 1s224 Summit Ave, Suite 310, Oakbrook Terrace, IL 60181-3983 2012-05-10
1811255813 Rizwana Mughal Internal Medicine 1s224 Summit Ave, Suite 310, Oakbrook Terrace, IL 60181-3983 2012-04-26
1609149566 Soft Landing Intervention Community/Behavioral Health 1s224 Summit Ave, Oakbrook Terrace, IL 60181-3983 2012-02-22
1588893929 Lea Ann Minalga Counselor 1s224 Summit Ave, Suite 310, Oakbrook Terrace, IL 60181-3983 2009-07-07
1275774044 Acmi Pain Care LLC Anesthesiology 1s224 Summit Ave, Ste 301, Oakbrook Terrace, IL 60181-3983 2009-03-09
1962647917 Julie Mather Jourdan Physician Assistant 1s224 Summit Ave, Suite 106, Oakbrook Terrace, IL 60181-3983 2008-12-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144820812 Molly Ahitow Pharmacist 900 Il-83, Villa Park, IL 60181 2020-10-30
1881200343 Podiatric Management Systems LLC Podiatrist 1 S067 Summit Ave, Oakbrook Terrace, IL 60181 2020-09-21
1093320855 Rci (wrs), LLC. Clinic/Center 17 West 580 Butterfield Road, Oakbrook Terrace, IL 60181 2020-09-09
1720600992 Mariam Ali Pharmacist 900 S. Rt 83, Villa Park, IL 60181 2020-05-11
1255970067 Lifecare Pharmacy Plus LLC Pharmacy 1634 Ardmore Ave, Villa Park, IL 60181 2019-12-26
1497229215 For Eyes Optical of Pa Optometrist 17 W 412-414 22nd St, Ste M&n, Oakbrook Terrace, IL 60181 2019-01-15
1114499928 Next Step Physiotherapy LLC Clinic/Center 1 Parkview Plaza, Oakbrook Terrace, IL 60181 2018-12-19
1912482654 Avertrail Dialysis LLC Clinic/Center 196 W. North Avenue, Villa Park, IL 60181 2018-09-28
1922588581 Neeliyara Inc Psychologist 1s045 Spring Road, Unit 1g, Oakbrook Terrace, IL 60181 2018-08-14
1588168439 Deborah Marie Adolfino Pedorthist 1s376 Summit Ave., Ct. E, Oakbrook Terrace, IL 60181 2018-03-23
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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730457201 Oakbrook Orthodontics Clinic/Center 17 W 727 Butterfield Road, Suite A, Oakbrook Terrace, IL 60181 2011-12-12
1518144906 Oak Brook Smiles, P.C. Clinic/Center 1s132 Summit Ave, #200, Oakbrook Terrace, IL 60181-3955 2008-01-28
1649455692 Westbrook Dental Center PC Clinic/Center 1 Transam Plaza Dr, Suite 160, Oakbrook Terrace, IL 60181-4822 2008-01-08
1669588778 Phyllis A. Dixon Dds PC Clinic/Center 17w620 14th St, Ste. G, Oakbrook Terrace, IL 60181-3768 2006-08-22

Providers in the same taxonomy and state

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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Competitor

Search similar providers

City OAKBROOK TERRACE
Zip Code 60181

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Dataset Information

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.

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