Healthcare Provider Details

I. General information

NPI: 1477968576
Provider Name (Legal Business Name): NAPER DENTAL SLEEP CENTER, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E 5TH AVE STE 420
NAPERVILLE IL
60563-3403
US

IV. Provider business mailing address

300 E 5TH AVE STE 420
NAPERVILLE IL
60563-3403
US

V. Phone/Fax

Practice location:
  • Phone: 630-369-6836
  • Fax: 630-369-7067
Mailing address:
  • Phone: 630-369-6836
  • Fax: 630-369-7067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019025348
License Number StateIL

VIII. Authorized Official

Name: DR. ANGELA PLANER VENEGONI
Title or Position: OWNER/ DENTIST
Credential: DDS, D.ABDSM
Phone: 630-369-6836