=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144175506
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAKE HILLS DENTAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2026
-----------------------------------------------------
Last Update Date | 03/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2110 W ALGONQUIN RD
-----------------------------------------------------
City | LAKE IN THE HILLS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60156-1370
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-803-8883
-----------------------------------------------------
Fax | 847-854-0451
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2110 W ALGONQUIN RD
-----------------------------------------------------
City | LAKE IN THE HILLS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60156-1370
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-803-8883
-----------------------------------------------------
Fax | 847-854-0451
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. BINDU GULATI
-----------------------------------------------------
Credential | D.D.S
-----------------------------------------------------
Telephone | 630-803-8883
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------