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PORTAGE PARK DENTAL STUDIO NPI 1659012920


NPI Information

NPI: 1659012920
Provider Name: PORTAGE PARK DENTAL STUDIO
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
5955 W IRVING PARK RD
CHICAGO, IL
ZIP 60634
Phone: (773) 481-9455
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PORTAGE PARK DENTAL STUDIO is a dental clinic center in Chicago, IL. PORTAGE PARK DENTAL STUDIO NPI is 1659012920. The provider is registered as an organization entity type.

The provider's business location address is:

5955 W IRVING PARK RD
CHICAGO, IL
ZIP 60634-618
Phone: (773) 481-9455

The provider's authorized official is Darren Dwayne Simpson .
The authorized official title is Owner and has the following contact phone number (708) 369-4076.

The enumeration date for this NPI number is 4/2/2022 and was last updated on 4/2/2022.


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
1261QD0000XClinic/CenterDentalYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.