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BRIGHTSMILES PEDIATRIC DENTISTRY NPI 1538472477


NPI Information

NPI: 1538472477
Provider Name: BRIGHTSMILES PEDIATRIC DENTISTRY
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
2550 W ADDISON ST STE A17
CHICAGO, IL
ZIP 60618
Phone: (773) 423-6050
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BRIGHTSMILES PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Chicago, IL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. BRIGHTSMILES PEDIATRIC DENTISTRY NPI is 1538472477. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2550 W ADDISON ST STE A17
CHICAGO, IL
ZIP 60618-939
Phone: (773) 423-6050

The provider's authorized official is H. Johnny I Kuttab .
The authorized official title is Pediatric Dentistry and has the following contact phone number (847) 971-8847.

The enumeration date for this NPI number is 7/20/2010 and was last updated on 2/16/2022.


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
11223P0221XDentistPediatric Dentistry019.027640ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11811155096OTHERILLINOISINDIVIDUAL NPI

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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