PSP Dental Services PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PSP DENTAL SERVICES PC

Practice address

5425 W 95TH St
Oak Lawn, IL 60453-2354

Phone

(708) 636-0565

Fax

(708) 636-0566

NPI assigned

Apr 23, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paraj Patel, DMDNPI 1265816995

Title

President

Phone

(201) 303-8996

Specialties & licenses 1

Addresses

Other names 1

• Roots Dental Studio Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paraj Suryakant Patel, D.M.D

  • General Practice Dentistry
  • Yorkville, IL
  • NPI 1265816995
  NPD Authorized official
• John Peter Fiorenza, D.D.S.

  • Dentist
  • Oak Lawn, IL
  • NPI 1346615648
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1366930604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532354",
            "telephone_number": "708-636-0565",
            "fax_number": "708-636-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532354",
            "telephone_number": "708-636-0565",
            "fax_number": "708-636-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSP DENTAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PARAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-303-8996",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roots Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle M Principato, PSY.D.
• Progressive Imaging Partners, LLC
• Denise Ann Prohaska, SLP-CCC
• Gail Prokop, APRN
• Jenna Ann Pronger
• PT Success Clinic Inc.
• Pulmonary Exchange, LTD.
• Gregory R Purdy, PT
• Nadeem Qamar, BS
• Nor Qashmer

• Dental Clinic/Center in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.