Healthcare Provider Details

I. General information

NPI: 1568393726
Provider Name (Legal Business Name): DENTISTRY AND BEYOND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6972 N CLARK ST
CHICAGO IL
60626-3221
US

IV. Provider business mailing address

6972 N CLARK ST
CHICAGO IL
60626-3221
US

V. Phone/Fax

Practice location:
  • Phone: 773-262-5898
  • Fax: 773-262-5897
Mailing address:
  • Phone: 773-262-5898
  • Fax: 773-262-5897

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. MAZEN EISHO
Title or Position: DENTIST
Credential: DMD
Phone: 773-952-9109