HUMBOLDT COMMUNITY DENTAL PC NPI 1942490149

NPI Information

  • NPI: 1942490149
  • Provider Name: HUMBOLDT COMMUNITY DENTAL PC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Doing Business As: SONRISA FAMILY DENTAL
  • Address: 1044 N MOZART ST
    SUITE 401
    CHICAGO, IL
    ZIP 60622
  • Phone: (773) 772-9200

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NPI Details

HUMBOLDT COMMUNITY DENTAL PC is a dental clinic center in Chicago, IL. HUMBOLDT COMMUNITY DENTAL PC NPI is 1942490149. The provider is registered as an organization entity type.
The provider Is Doing Business As Sonrisa Family Dental.

The provider's business location address is:

1044 N MOZART ST
SUITE 401
CHICAGO, IL
ZIP 60622-789
Phone: (773) 772-9200
Fax: (773) 772-9203

The provider's authorized official is Jason Korkus .
The authorized official title is President and has the following contact phone number (773) 772-9200.

The enumeration date for this NPI number is 7/25/2007 and was last updated on 7/25/2007.

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
1261QD0000XClinic/CenterDentalILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1163914MEDICAIDILLINOIS

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: 11/21/2025

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