PEARL DENTAL LLC NPI 1558649368

NPI Information

NPI: 1558649368
Provider Name: PEARL DENTAL LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4527 N PULASKI RD
CHICAGO, IL
ZIP 60630
Phone: (630) 240-1984
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PEARL DENTAL LLC is a dental clinic center in Chicago, IL. PEARL DENTAL LLC NPI is 1558649368. The provider is registered as an organization entity type.

The provider's business location address is:

4527 N PULASKI RD
CHICAGO, IL
ZIP 60630-415
Phone: (630) 240-1984

The provider's authorized official is Fawaz Kannout .
The authorized official title is Dds and has the following contact phone number (630) 240-1984.

The enumeration date for this NPI number is 7/27/2011 and was last updated on 7/27/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	019024870	ILLINOIS	Yes

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: 11/14/2023

NPI Synchronization or Removal

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