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General NPI Number Information
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NPI Number | 1871472555
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Entity Type | Organization
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Legal Business Name | 6 CORNERS DENTAL STUDIO PC
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 3946 N CICERO AVE
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City | CHICAGO
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State | IL
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Zip | 60641-2711
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Country | US
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Telephone | 630-709-3398
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Fax |
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Provider Business Mailing Address
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Address Line | 6426 N NORTHWEST HWY
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City | CHICAGO
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State | IL
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Zip | 60631-1450
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Country | US
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Telephone | 773-631-5200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARREN SIMPSON
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Credential | DDS
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Telephone | 708-369-4076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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