MEDICARE: FARMINGTON LAKES 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	261QD0000X	Dental Clinic/Center	019025947	IL

General Provider Information

NPI Number	:	1437403029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARMINGTON LAKES DENTAL

Provider Business Mailing Address
First Line	:	1241 FARMINGTON LAKES DR
Second Line	:
City	:	OSWEGO
State	:	IL
Zip	:	60543-5109
Country	:	US
Telephone Number	:	331-212-5085
Fax Number	:

Provider Business Practice Location Address
First Line	:	1241 FARMINGTON LAKES DR
Second Line	:
City	:	OSWEGO
State	:	IL
Zip	:	60543-5109
Country	:	US
Telephone Number	:	331-212-5085
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KABIL CHUNPRAPAPH
Credential	:	D.M.D.
Telephone Number	:	331-212-5085

Provider Enumeration Date	:	11/03/2012
Last Update Date	:	11/03/2012

Similar Medicare Providers

1790179976 — BALANCED BODY CHIROPRACTIC LLC
Practice Location Address:

1231 FARMINGTON LAKES DR , SUITE 101
OSWEGO, IL
60543-5109

Practice Phone: 331-212-6962
Practice Fax: 630-429-9276

1568984599 — CHRISTIN WHITT-SOLECKI BCBA
Practice Location Address:

1211 FARMINGTON LAKES DR
OSWEGO, IL
60543-5109

Practice Phone: 815-469-1500
Practice Fax:

1598288946 — MISS HEATHER J GROETZENBACH SLP
Practice Location Address:

1221 FARMINGTON LAKES DR
OSWEGO, IL
60543-5109

Practice Phone: 630-509-4166
Practice Fax:

1497220362 — ANDREA LIVINGSTON
Practice Location Address:

1211 FARMINGTON LAKES DR
OSWEGO, IL
60543-5109

Practice Phone: 815-469-1500
Practice Fax:

1679103568 — ALISSA STAUFFER
Practice Location Address:

1211 FARMINGTON LAKES DR
OSWEGO, IL
60543-5109

Practice Phone: 630-509-4166
Practice Fax:

1730787532 — MRS. ELIZABETH WARREN BCBA
Practice Location Address:

1211 FARMINGTON LAKES DR
OSWEGO, IL
60543-5109

Practice Phone: 815-468-1500
Practice Fax:

Directions to “FARMINGTON LAKES DENTAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.