Healthcare Provider Details

I. General information

NPI: 1457432734
Provider Name (Legal Business Name): ALAN W. KAPLIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S BARTLETT RD
STREAMWOOD IL
60107-2421
US

IV. Provider business mailing address

820 S BARTLETT RD
STREAMWOOD IL
60107-2421
US

V. Phone/Fax

Practice location:
  • Phone: 630-830-9700
  • Fax: 630-830-9739
Mailing address:
  • Phone: 630-830-9700
  • Fax: 630-830-9739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberA11804
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: