PEARL DENTAL LLC – NPI #1558649368
Clinic/Center

PEARL DENTAL LLC is an AHC clinic located in CHICAGO, IL. NPPES has assigned the NPI number 1558649368 to PEARL DENTAL LLC on July 27, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PEARL DENTAL LLC below.

NPI Profile for
PEARL DENTAL LLC

NPI Number
1558649368
Enumeration Date

(about 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PEARL DENTAL LLC
Primary location
4527 N PULASKI RD
CHICAGO, IL 60630-4415
Phone: (630) 240-1984 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
FAWAZ KANNOUT
DDS
Phone: (630) 240-1984
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 IL 019024870

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.