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NPI Code Detail

MEDICARE: UNITED DENTAL SURGERY INC

MEDICARE: UNITED DENTAL SURGERY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1023827029
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNITED DENTAL SURGERY INC
Provider Business Mailing Address
First Line : 3100 LEXINGTON LN APT 112
Second Line :
City : GLENVIEW
State : IL
Zip : 60026-5936
Country : US
Telephone Number : 847-668-9616
Fax Number :
Provider Business Practice Location Address
First Line : 8501 S CICERO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60652-3504
Country : US
Telephone Number : 847-668-9616
Fax Number :
Authorized Official
Title or Position : DOCTOR
Name : DR. KEVIN KORDI
Credential : DMD
Telephone Number : 847-668-9616
Provider Enumeration Date : 01/03/2025
Last Update Date : 01/03/2025

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Directions to “UNITED DENTAL SURGERY INC ” Practice Location

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