Healthcare Provider Details

I. General information

NPI: 1457015513
Provider Name (Legal Business Name): NKS DENTAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 OGDEN AVE STE 114
LISLE IL
60532-1976
US

IV. Provider business mailing address

3033 OGDEN AVE STE 114
LISLE IL
60532-1976
US

V. Phone/Fax

Practice location:
  • Phone: 262-496-0999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NEHA KAPILA
Title or Position: PRESIDENT
Credential:
Phone: 262-496-0999