LAKEVIEW SMILES EDGEWATER LTD NPI 1700532470

NPI Information

NPI: 1700532470
Provider Name: LAKEVIEW SMILES EDGEWATER LTD
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
6351 N BROADWAY ST UNIT A
CHICAGO, IL
ZIP 60660
Phone: (312) 584-0510
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LAKEVIEW SMILES EDGEWATER LTD is a dental clinic center in Chicago, IL. LAKEVIEW SMILES EDGEWATER LTD NPI is 1700532470. The provider is registered as an organization entity type.

The provider's business location address is:

6351 N BROADWAY ST UNIT A
CHICAGO, IL
ZIP 60660-401
Phone: (312) 584-0510
Fax: (312) 584-0541

The provider's authorized official is Grace Lee .
The authorized official title is President and has the following contact phone number (773) 929-1150.

The enumeration date for this NPI number is 2/22/2022 and was last updated on 2/22/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	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: 11/14/2023

NPI Synchronization or Removal

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