PSP DENTAL SERVICES P.C. (NPI# 1366930604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366930604 |
| Entity Type | Organization |
| Organization Name | PSP DENTAL SERVICES P.C. |
| Other Organization Name | ROOTS DENTAL STUDIO |
| Practice Address |
5425 W 95th St Oak Lawn IL 60453-2354 |
| Practice Telephone | 7086360565 |
| Practice Fax Number | 7086360566 |
| Mailing Telephone | 7086360565 |
| Mailing Fax Number | 7086360566 |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |
| Authorized Official Name | DR. PARAJ SURYAKANT PATEL (PRESIDENT) |
| Authorized Official Telephone | 7086360565 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Roots Dental Studio | Doing Business As Name - Organization |
| Street Address |
5425 W 95TH ST |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-2354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346615648 | John Peter Fiorenza | Dentist | 5425 W 95th St, Oak Lawn, IL 60453-2354 | 2015-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995231 | Natalia Zero | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 | 2020-05-30 |
| 1114554300 | Sylvia Maria Chlebek | Student in an Organized Health Care Education/Training Program | Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 | 2020-03-26 |
| 1972066751 | Amanda Mroczek | Family Medicine | 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-09 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1659833473 | Chelsea Sumida Gipson | Family Medicine | 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-01 |
| 1518427418 | Robert Lindgren | Family Medicine | 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 | 2019-03-25 |
| 1154886695 | Stephanie Anne Comer | Social Worker | 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 | 2019-02-08 |
| 1700360070 | Brian L Lee | Counselor | 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 | 2018-09-21 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1124538301 | Kavitha Rajendran | Physician Assistant | 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 | 2017-10-02 |
| Find all providers in zip 60453 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558984427 | Decker Family Dental, PC | Clinic/Center | 4647 W 103rd St Ste 1d, Oak Lawn, IL 60453-4792 | 2020-05-26 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1740436120 | Thomas J King Jr Dds PC | Clinic/Center | 10735 S Cicero Ave, Oak Lawn, IL 60453-5400 | 2008-08-17 |
| 1962581736 | Brosnan Dental Ltd | Clinic/Center | 10522 S Cicero Ave, Suite 204, Oak Lawn, IL 60453-5200 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629514 | Chicago Pediatric Dentistry and Orthodontics | Clinic/Center | 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 | 2020-11-03 |
| 1437750031 | Secure Dental Xi | Clinic/Center | 1843 W Golf Rd, Schaumburg, IL 60194-1148 | 2020-11-02 |
| 1780283267 | Jenna Gaw, Dds, Pllc | Clinic/Center | 1724 Locust Pl Apt 303, Schaumburg, IL 60173-4239 | 2020-10-26 |
| 1740889344 | Nsp Dental LLC | Clinic/Center | 1900 Hollister Dr Ste 190, Libertyville, IL 60048-5283 | 2020-10-23 |
| 1285232827 | Paul Doodes Dds Phd PC | Clinic/Center | 45 S Park Blvd Ste 190, Glen Ellyn, IL 60137-6282 | 2020-10-15 |
| 1780290676 | Great Smile Dental Pllc | Clinic/Center | 720 Osterman Ave Ste 304, Deerfield, IL 60015-4339 | 2020-09-16 |
| 1669087375 | Naperville Smiles Dental | Clinic/Center | 8 W Gartner Rd Ste 124, Naperville, IL 60540-7549 | 2020-09-09 |
| 1649883364 | Mark J Maly Estate | Clinic/Center | 103 S Main St # Po, Orangeville, IL 61060-9244 | 2020-08-24 |
| 1760094718 | Stoffel and Tomazin Dental Associates, Ltd | Clinic/Center | 5718 W 35th St, Cicero, IL 60804-4222 | 2020-08-20 |
| 1215548771 | Meda Dental II LLC | Clinic/Center | 2735 Hassert Blvd Ste 159, Naperville, IL 60564-5205 | 2020-08-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.