MEDICARE: NORTHWEST DENTAL ASSOCIATES, LLC

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
1	122300000X	Dentist		IL

General Provider Information

NPI Number	:	1962671230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST DENTAL ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	1751 W GOLF RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4025
Country	:	US
Telephone Number	:	847-593-0510
Fax Number	:

Provider Business Practice Location Address
First Line	:	1751 W GOLF RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4025
Country	:	US
Telephone Number	:	847-593-0510
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JASON CHENG
Credential	:	DDS
Telephone Number	:	847-593-0510

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	02/20/2008

Similar Medicare Providers

1447474879 — THE EYE SITE OF ILLINOIS, LLC
Practice Location Address:

1717 W GOLF RD
MOUNT PROSPECT, IL
60056-4025

Practice Phone: 847-437-1414
Practice Fax: 847-437-9763

1255509600 — DR. JASON JYH-JEN CHENG DDS
Practice Location Address:

1751 W GOLF RD
MOUNT PROSPECT, IL
60056-4025

Practice Phone: 847-593-0510
Practice Fax:

1487655635 — DR. JAMIE L SOUTHARD DC
Practice Location Address:

113 S 11TH ST
MOUNT VERNON, WA
98274-4025

Practice Phone: 360-488-2123
Practice Fax: 360-404-3906

1427249606 — YOLANDA SAKUMA LMP
Practice Location Address:

113 S 11TH ST
MOUNT VERNON, WA
98274-4025

Practice Phone: 360-421-0435
Practice Fax: 360-404-3906

1235594516 — JAMIE L SOUTHARD DC PC
Practice Location Address:

113 S 11TH ST
MOUNT VERNON, WA
98274-4025

Practice Phone: 360-488-2123
Practice Fax: 360-404-3906

1902753742 — JM SUPPLIES INC
Practice Location Address:

259 E RAND RD STE 205
MOUNT PROSPECT, IL
60056-2184

Practice Phone: 510-944-6583
Practice Fax:

Directions to “NORTHWEST DENTAL ASSOCIATES, LLC ” 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.