Healthcare Provider Details

I. General information

NPI: 1205745205
Provider Name (Legal Business Name): ACME DENTISTRY HOBART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7878 E. RIDGE RD. SUITE H.
HOBART IN
46342-2468
US

IV. Provider business mailing address

10114 GRAND AVE.
FRANKLIN PARK IL
60131-2549
US

V. Phone/Fax

Practice location:
  • Phone: 219-400-0878
  • Fax: 224-781-0660
Mailing address:
  • Phone: 847-737-7886
  • Fax: 224-781-0660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: IDALY CANIZALES
Title or Position: OFFICE MANAGER
Credential:
Phone: 847-737-7886