Healthcare Provider Details

I. General information

NPI: 1831072214
Provider Name (Legal Business Name): BLOOMINGDALE DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 E LAKE ST STE A
BLOOMINGDALE IL
60108-1159
US

IV. Provider business mailing address

156 E LAKE ST STE A
BLOOMINGDALE IL
60108-1159
US

V. Phone/Fax

Practice location:
  • Phone: 773-610-1041
  • Fax:
Mailing address:
  • Phone: 773-610-1041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JUBRAIL SWEIS
Title or Position: OWNER
Credential: D.D.S
Phone: 773-610-1041