Independence Family Dental in Chicago - Dentist
Independence Family Dental - NPI 1164406138
Independence Family Dental is a Dentist in Chicago, Illinois. Independence Family Dental practices all healthcare services and medical treatments related to Dentist. The NPI Number for Independence Family Dental is 1164406138. The last update date is 2020-08-22.
Independence Family Dental's current location address is 4703 W Lawrence Ave, Chicago, Illinois. You can contact this provider via phone number 7732059900 and fax number 7732059970. The mailing address for Independence Family Dental is 4703 W Lawrence Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Independence Family Dental |
|---|---|
| Address | 4703 W Lawrence Ave, Chicago, Illinois |
| Phone Number | 7732059900 |
| Fax Number | 7732059970 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Azab E Emad |
| Credentials | DDS |
| Telephone Number | 7732059900 |
NPI Number Detail
| NPI Number | 1164406138 |
|---|---|
| Provider Enumeration Date | 2005-12-02 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 4703 W Lawrence Ave |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606301722 |
| Phone Number | 7732059900 |
| Fax Number | 7732059970 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
|
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 101611 | IL | -- |
Post Comment/ Review Below
What is the Independence Family Dental's unique identification number?
The Independence Family Dental has been assigned the NPI (National Provider Identifier) Number 1164406138 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete physical location address of Independence Family Dental?
The Independence Family Dental is physically situated at 4703 W Lawrence Ave, in the city of Chicago, state of IL, with the postal code 606301722.
What is Independence Family Dental's specialized field of practice, and what is the corresponding taxonomy classification code?
The Independence Family Dental's area of specialization is Dentist, and the corresponding taxonomy code that categorizes this field of practice is 122300000X.
When was the Independence Family Dental's 1164406138 issued?
The Independence Family Dental's 1164406138 was issued on 2005-12-02.
When was the information pertaining to Independence Family Dental most recently updated or revised?
The details related to Independence Family Dental, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.