Healthcare Provider Details
I. General information
NPI: 1700911146
Provider Name (Legal Business Name): THE DENTAL SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6319 FAIRVIEW AVE 103
WESTMONT IL
60559-2888
US
IV. Provider business mailing address
6319 FAIRVIEW AVE 103
WESTMONT IL
60559-2888
US
V. Phone/Fax
- Phone: 630-960-4447
- Fax: 630-960-3135
- Phone: 630-960-4447
- Fax: 630-960-3135
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0106X |
| Taxonomy | Oral and Maxillofacial Pathology Dentistry |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAJAN
SHARMA
Title or Position: OWNER
Credential: D.D.S., M.S.D.
Phone: 630-960-4447