Charles J Bagdade, D.D.S.
Individual provider Active NPI General Practice Dentistry · Vernon Hills, IL
NPI 1649239195 · NPPES record last updated Mar 3, 2009
Key facts
- NPI
- 1649239195
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019-013723 (IL)
- Practice address
- 125 E Townline Rd
Vernon Hills, IL 60061-1424 - Phone
- (847) 367-4890
- Fax
- (847) 367-4891
- NPI assigned
- Mar 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 019-013723 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019-013723 | IL | Yes |
Addresses
Primary practice location
125 E Townline Rd
Vernon Hills, IL 60061-1424
Mailing address
125 E Townline Rd
Vernon Hills, IL 60061-1424
Phone (847) 367-4890
Other providers in Vernon Hills, IL
- Tara Atta
- Stephanie Marie Aubuchon
- Crystal Ayala
- Elizabeth Ayers
- Teresa Bae
- Hayder F. Bahrani
- Howard R Baker
- Justin Baker
- Fadi Bakhos
- Amanda Bakken
All providers in Vernon Hills, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2009. 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.