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General NPI Number Information
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NPI Number | 1275458549
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Entity Type | Organization
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Legal Business Name | HELIOS DENTAL CENTER PLLC
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 203 N LASALLE BLVD UNIT #230 MEZZANINE LEVEL
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City | CHICAGO
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State | IL
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Zip | 60601
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Country | US
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Telephone | 954-997-4175
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Fax |
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Provider Business Mailing Address
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Address Line | 203 N LASALLE BLVD UNIT #230 MEZZANINE LEVEL
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City | CHICAGO
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State | IL
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Zip | 60601
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Country | US
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Telephone | 954-997-4175
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | JONATHAN PHEN
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Credential | DMD
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Telephone | 954-997-4175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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