Best Smile Dentistry, LLC
Organization Active NPI Periodontics · Roselle, IL
NPI 1326316746 · NPPES record last updated Dec 13, 2011
Key facts
- NPI
- 1326316746
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Periodontics 1223P0300X
- License
- 021.002403 (IL)
- Legal business name
- BEST SMILE DENTISTRY, LLC
- Practice address
- 490 W Lake St
107
Roselle, IL 60172-3583 - Phone
- (614) 657-8312
- NPI assigned
- Dec 13, 2011
- Organization subpart
- No
Authorized official
- Name
- Praveen Kumar Gajendrareddy, DDS
- Title
- Member/ Manager
- Phone
- (614) 657-8312
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics |
1223P0300X | 021.002403 | IL | Yes |
Addresses
Primary practice location
490 W Lake St
107
Roselle, IL 60172-3583
Mailing address
1841 Maine Dr
Elk Grove Village, IL 60007-2728
Phone (614) 657-8312
Other providers in Roselle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2011. 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.