BRISTLE DENTAL STUDIO NPI 1578246930

NPI Information

NPI: 1578246930
Provider Name: BRISTLE DENTAL STUDIO
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1700 N WESTERN AVE UNIT A
CHICAGO, IL
ZIP 60647
Phone: (312) 620-7733
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BRISTLE DENTAL STUDIO is a dental clinic center in Chicago, IL. BRISTLE DENTAL STUDIO NPI is 1578246930. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1700 N WESTERN AVE UNIT A
CHICAGO, IL
ZIP 60647-324
Phone: (312) 620-7733

The provider's authorized official is Connie J Woo .
The authorized official title is Owner and has the following contact phone number (224) 612-1383.

The enumeration date for this NPI number is 8/10/2023 and was last updated on 1/5/2024.

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	1223G0001X	Dentist	General Practice			No
2	261QD0000X	Clinic/Center	Dental			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: 5/5/2024

NPI Synchronization or Removal

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