LINCOLN PARK DENTAL SPECIALISTS (NPI# 1669699880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669699880 |
| Entity Type | Organization |
| Organization Name | LINCOLN PARK DENTAL SPECIALISTS |
| Practice Address |
1960 N Lincoln Park W 2nd Floor Chicago IL 60614-5487 |
| Practice Telephone | 7733273131 |
| Practice Fax Number | 7733273208 |
| Mailing Telephone | 7733273131 |
| Mailing Fax Number | 7733273208 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MISS DEDE LUSH (MANAGER) |
| Authorized Official Telephone | 7733273131 |
| Authorized Official Credential | RDH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| X | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| X | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
1960 N LINCOLN PARK W 2ND FLOOR |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-5487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689726572 | Hubert Dolezal | Psychologist | 1960 N Lincoln Park W, Chicago, IL 60614-5487 | 2007-01-18 |
| 1215362686 | Kathleen Farrell | Counselor | 1960 N Lincoln Park W, Apt. 2312, Chicago, IL 60614-5487 | 2013-09-04 |
| 1922293133 | Milton Lee Davenport IIi | Dentist | 1960 N Lincoln Park W, Chicago, IL 60614-5487 | 2007-09-11 |
| 1558588897 | Thomas G Manos | Dentist | 1960 N Lincoln Park W, 2nd Floor, Chicago, IL 60614-5487 | 2007-04-19 |
| 1013134378 | Paul Vizgirda | Dentist | 1960 N Lincoln Park W, 2nd Floor, Chicago, IL 60614-5487 | 2007-04-19 |
| 1851518047 | Alphonse V Gargiulo | Dentist | 1960 N Lincoln Park W, 2nd Flr, Chicago, IL 60614-5487 | 2007-04-19 |
| 1548398365 | Albert Zickmann | Dentist | 1960 N Lincoln Park W, 2nd Floor, Chicago, IL 60614-5487 | 2007-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942793815 | Millennium Dental Specialist | Dentist | 1624 W Division St Ste B, Chicago, IL 60622-3908 | 2018-06-14 |
| 1629453378 | Charles Richard Neach | Dentist | 801 S Paulina St Rm 302a, Chicago, IL 60612-7210 | 2015-07-23 |
| 1962841601 | Vikash Suresh Huliyar | Dentist | 111 N Wabash Ave Ste 1517, Chicago, IL 60602 | 2013-06-16 |
| 1245678473 | Advanced Endodontics of Chicago | Dentist | 111 N Wabash Ave Ste 812, Chicago, IL 60602-1912 | 2013-06-10 |
| 1780020461 | Kimberly Smiles | Dentist | 1835 N Milwaukee Ave, Cw, Chicago, IL 60647-6186 | 2013-05-21 |
| 1619237088 | David Gilbert Oser | Dentist | 901 W Madison St Unit 619, Chicago, IL 60607-3372 | 2012-05-20 |
| 1922331370 | Susan Rutherford Torma | Dentist | 1642 W. Belmont Ave, Chicago, IL 60657 | 2009-09-16 |
| 1477723302 | Clarence Towns Jr. | Dentist | 8741 South Greenwood Ave, Suite 107, Chicago, IL 60619 | 2008-03-06 |
| 1508035619 | Innovative Endodontics, P.C. | Dentist | 4346 N Pulaski Rd # Ab, Chicago, IL 60641-2156 | 2008-02-22 |
| 1881813970 | Priscilla Yeung | Dentist | 1725 W North Ave, Suite 102, Chicago, IL 60622-2188 | 2007-04-25 |
| Find all providers in CHICAGO | ||||
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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.