Healthcare Provider Details

I. General information

NPI: 1568886398
Provider Name (Legal Business Name): ALL ABOUT SMILES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W WING ST
ARLINGTON HEIGHTS IL
60005-1433
US

IV. Provider business mailing address

121 W WING ST
ARLINGTON HEIGHTS IL
60005-1433
US

V. Phone/Fax

Practice location:
  • Phone: 847-255-3185
  • Fax: 847-255-9890
Mailing address:
  • Phone: 847-255-3185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number019025474
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DIMPLE TEJANI
Title or Position: DENTIST
Credential:
Phone: 847-255-3815