Healthcare Provider Details

I. General information

NPI: 1104471333
Provider Name (Legal Business Name): HIGHWAY DENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2019
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E ARMY TRAIL RD STE 302
BLOOMINGDALE IL
60108-2138
US

IV. Provider business mailing address

908 EDEN DR
SCHAUMBURG IL
60195-3235
US

V. Phone/Fax

Practice location:
  • Phone: 630-980-5388
  • Fax:
Mailing address:
  • Phone: 224-578-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. EUN-HEE LEE
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 224-578-1300