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WICKER PARK DENTAL LTD NPI 1003962192


NPI Information

NPI: 1003962192
Provider Name: WICKER PARK DENTAL, LTD

Doing Business As: WICKER PARK DENTAL GROUP

Classification: Dentist - 122300000X
Entity Type: Organization
Address:
1738 W NORTH AVE
CHICAGO, IL
ZIP 60622
Phone: (773) 276-5566
Get Directions

WICKER PARK DENTAL, LTD is a dentist in Chicago, IL. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. WICKER PARK DENTAL, LTD NPI is 1003962192. The provider is registered as an organization entity type.
The provider Is Doing Business As Wicker Park Dental Group.

The provider's business location address is:

1738 W NORTH AVE
CHICAGO, IL
ZIP 60622
Phone: (773) 276-5566
Fax: (773) 276-8780

The provider's authorized official is Nidza Alicea .
The authorized official title is Office Manager and has the following contact phone number (773) 235-0980.

The enumeration date for this NPI number is 1/25/2007 and was last updated on 2/9/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QD0000XClinic/CenterDentalNo
2122300000XDentist060010054ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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