Healthcare Provider Details

I. General information

NPI: 1346160330
Provider Name (Legal Business Name): JONATHAN BEDI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 S MAIN ST STE 241
NAPERVILLE IL
60540-5377
US

IV. Provider business mailing address

55 S MAIN ST STE 241
NAPERVILLE IL
60540-5377
US

V. Phone/Fax

Practice location:
  • Phone: 630-848-2010
  • Fax:
Mailing address:
  • Phone: 630-848-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019037344
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: