DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BRIDGEPORT SMILES

MEDICARE: BRIDGEPORT SMILES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry019026249IL

General Provider Information

NPI Number : 1528487220
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGEPORT SMILES
Provider Business Mailing Address
First Line : 3014 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-5805
Country : US
Telephone Number : 312-291-9283
Fax Number :
Provider Business Practice Location Address
First Line : 3014 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-5805
Country : US
Telephone Number : 312-291-9283
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. NEEPA MODI
Credential : DDS
Telephone Number : 312-291-9283
Provider Enumeration Date : 04/09/2014
Last Update Date : 09/02/2014

Similar Medicare Providers

1487638920 — DR. SHELDON LO DPT, MS, ATC
Practice Location Address:
3008 S HALSTED ST , SUITE 116
CHICAGO, IL
60608-5805
Practice Phone: 312-842-1205
Practice Fax: 312-842-1356
1891701330 — WALGREEN CO
Practice Location Address:
3000 S HALSTED ST
CHICAGO, IL
60608-5805
Practice Phone: 312-225-0537
Practice Fax: 312-225-1015
1356668586 — ATHLETIC AND THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC
Practice Location Address:
3008 S HALSTED ST , SUITE 116
CHICAGO, IL
60608-5805
Practice Phone: 312-842-1205
Practice Fax: 312-842-1356
1609159771 — CAROLYN LIGUE
Practice Location Address:
3000 S HALSTED ST
CHICAGO, IL
60608-5805
Practice Phone: 312-225-0537
Practice Fax: 312-225-1015
1669891800 — ANDREW MOY PT
Practice Location Address:
3008 S HALSTED ST , SUITE 116
CHICAGO, IL
60608-5805
Practice Phone: 312-842-1205
Practice Fax: 312-842-1356
1609229046 — KWONG LAM PTA
Practice Location Address:
3008 S HALSTED ST , SUITE 116
CHICAGO, IL
60608-5805
Practice Phone: 312-842-1205
Practice Fax: 312-842-1356

Directions to “BRIDGEPORT SMILES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.