KO DENTAL CARE P.C. (NPI# 1386021954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386021954 |
| Entity Type | Organization |
| Organization Name | KO DENTAL CARE P.C. |
| Practice Address |
3434 W Peterson Ave Suite 1d Chicago IL 60659-3319 |
| Mailing Address |
2840 W Berwyn Ave Chicago IL 60625-3402 |
| Practice Telephone | 8722087573 |
| Practice Fax Number | 8728060113 |
| Mailing Telephone | 8722087573 |
| Mailing Fax Number | 8728060113 |
| Enumeration Date | 2015-05-02 |
| Last Update Date | 2015-05-02 |
| Authorized Official Name | JAE KO (PRESIDENT) |
| Authorized Official Telephone | 6462205353 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019027485 | IL | Dental Providers |
| Street Address |
3434 W PETERSON AVE SUITE 1D |
| City | CHICAGO |
| State | IL |
| Zip Code | 60659-3319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114909363 | Annie John, M.d.s.c. | Licensed Practical Nurse | 3434 W Peterson Ave, 1a, Chicago, IL 60659-3319 | 2005-11-15 |
| 1457526063 | Key I. Nam, Md, Sc. | Specialist/Technologist | 3434 W Peterson Ave, Suite 202, Chicago, IL 60659-3319 | 2008-04-24 |
| 1992979058 | Hugo H Muriel Mdsc | Internal Medicine | 3434 W Peterson Ave, Chicago, IL 60659 | 2008-04-18 |
| 1558534826 | Sheldon D Schwartz Md Sc | Internal Medicine | 3434 W Peterson Ave, Suite #1a, Chicago, IL 60659-3300 | 2008-04-08 |
| 1013106830 | Jae Ko | Dentist | 3434 W Peterson Ave, Suite 1d, Chicago, IL 60659-3319 | 2007-10-17 |
| 1922180330 | Keith K Nam | Internal Medicine | 3434 W Peterson Ave, Suite 202, Chicago, IL 60659-3319 | 2006-10-19 |
| 1306866124 | Tong Su Kim | Pediatrics | 3434 W Peterson Ave, 1c, Chicago, IL 60659 | 2006-07-21 |
| 1295760783 | Jalajakshi Potluri | Internal Medicine | 3434 W Peterson Ave, Chicago, IL 60659-3319 | 2006-07-12 |
| 1225013998 | Annie John | Internal Medicine | 3434 W Peterson Ave, 1a, Chicago, IL 60659-3319 | 2005-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811425 | Devon Homecare Physicians Inc. | Family Medicine | 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 | 2020-11-03 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1508410069 | Kara Lyn Anderson | Counselor | 2551 W. Peterson Ave, Chicago, IL 60659 | 2019-08-01 |
| 1568980019 | Saba Suleman | Counselor | 5815 N Spaulding Ave Apt 3a, Chicago, IL 60659 | 2017-09-05 |
| 1639695257 | Go Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5862 N Lincoln Ave, Suite 4, Chicago, IL 60659 | 2017-08-15 |
| 1972039568 | Trilogy, Inc. | Community/Behavioral Health | 2551 W Peterson Ave, Chicago, IL 60659 | 2017-05-03 |
| 1689029050 | Soulu | Voluntary or Charitable | 3557 W Peterson Ave #122, Chicago, IL 60659 | 2016-05-04 |
| 1730540550 | Michael Wei-tsi Chien | Dentist | 3425 W Peterson Ave Ste 107, Chicago, IL 60659 | 2016-03-08 |
| 1497129688 | Acquaint Homecare LLC | Home Health | 3525 West Peterson Avenue, Unit 118, Chicago, IL 60659 | 2015-11-25 |
| 1083054621 | Rebecca Schnell | Speech-Language Pathologist | 6124 N Saint Louis Ave, Chicago, IL 60659 | 2013-06-27 |
| Find all providers in zip 60659 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1679181895 | Robert J Chacon | Dentist | 15 S Throop St Apt 206, Chicago, IL 60607-2522 | 2020-07-14 |
| 1629693304 | Priyanka Sikka | Dentist | 300 W Grand Ave Apt 303, Chicago, IL 60654-7855 | 2020-06-09 |
| 1164045456 | Yong Chang Dds PC. | Dentist | 3531 N Western Ave Unit B, Chicago, IL 60618-6025 | 2020-05-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1831749944 | Kenwood Dental Group | Dentist | 1335 E 87th St Ste A, Chicago, IL 60619-7036 | 2019-09-19 |
| 1508412875 | Kamal Paresh Patel | Dentist | 1040 W Randolph St, Chicago, IL 60607-2215 | 2019-08-13 |
| 1003469636 | Ahmed Mansour | Dentist | 2122 N Milwaukee Ave Ste 1, Chicago, IL 60647-4251 | 2019-07-23 |
| 1568024925 | John Michael Burnheimer II | Dentist | 11 S Green St Unit 1106, Chicago, IL 60607-1031 | 2019-07-05 |
| 1497317515 | Prasanth Dommaraju | Dentist | 3924 S Archer Ave, Chicago, IL 60632-1116 | 2019-06-29 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on KO DENTAL CARE P.C..
| 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.