Amiel George Pappas, DDS
Individual provider Active NPI Dentist · Hometown, IL
NPI 1063534832 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1063534832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- Practice address
- 4084 Southwest Highway
Hometown, IL 60456-1100 - Phone
- (708) 424-8110
- Fax
- (708) 425-3878
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019023290 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Dental Care PC | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | Yes |
Addresses
Primary practice location
4084 Southwest Highway
Hometown, IL 60456-1100
Mailing address
4084 Southwest Highway
Hometown, IL 60456-1100
Phone (708) 424-8110
Other providers in Hometown, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.