Old Orchard Periodontics & Implant Dentistry LTD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

021001143 Issued in IL

Legal business name

OLD ORCHARD PERIODONTICS & IMPLANT DENTISTRY LTD

Practice address

4905 Old Orchard Shopping Ctr
Suite 310
Skokie, IL 60077-1425

Phone

(847) 982-0640

Fax

(847) 982-0644

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David Barack, DDS, PERIODONTISTNPI 1497842132

Title

Owner

Phone

(847) 982-0640

Specialties & licenses 1

Addresses

Practitioners 3

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

• David Barack, D.D.S.

  • Periodontics
  • Skokie, IL
  • NPI 1497842132
  NPD (past) Authorized official
• Chander Gupta, DMD

  • Periodontics
  • Skokie, IL
  • NPI 1801333026
  NPD (past)
• Michael Robert Oremland, D.D.S.

  • Periodontics
  • Skokie, IL
  • NPI 1265530711
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1821139171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR STE 310",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774740",
            "telephone_number": "847-982-0640",
            "fax_number": "847-982-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD SHOPPING CTR",
            "address_2": "SUITE 310",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771425",
            "telephone_number": "847-982-0640",
            "fax_number": "847-982-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD ORCHARD PERIODONTICS & IMPLANT DENTISTRY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "BARACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-982-0640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PERIODONTIST"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021001143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makanjuola Olabiyi
• Old Orchard Dental Group P.C.
• Old Orchard Endodontics
• Old Orchard Health Medical and Rehab Ctr LTD
• Old Orchard Obstetrics&Gynecology, S.C.
• Lisa Oldson, M.D.
• Margaret M Oleary, DPT
• Alisa L Oler, RDN
• Mary Oleszek, M.S., CCC-SLP
• Muna Oli

• Periodontics in Skokie, IL
• Providers in Skokie, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.