MEDICARE: LHK DENTAL

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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1316119456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LHK DENTAL

Provider Business Mailing Address
First Line	:	5642 W ROOSEVELT RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60644-1576
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5642 W ROOSEVELT RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60644-1576
Country	:	US
Telephone Number	:	773-473-8888
Fax Number	:

Authorized Official
Title or Position	:	DDS
Name	:	DR. PETER LIM
Credential	:
Telephone Number	:	773-473-8888

Provider Enumeration Date	:	03/28/2008
Last Update Date	:	03/28/2008

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Directions to “LHK DENTAL ” Practice Location

Language	Start Address	Practice Location

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