MEDICARE: KINTSUGI GROUP PLLC

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	:	1477409829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINTSUGI GROUP PLLC

Provider Business Mailing Address
First Line	:	1879 N MILWAUKEE AVE STE 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5689
Country	:	US
Telephone Number	:	312-429-6506
Fax Number	:

Provider Business Practice Location Address
First Line	:	1879 N MILWAUKEE AVE STE 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5689
Country	:	US
Telephone Number	:	312-429-6506
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUIS PERALTA
Credential	:	DMD
Telephone Number	:	917-742-4608

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

Similar Medicare Providers

1619516556 — DR. LUIS ALBERTO PERALTA DMD
Practice Location Address:

1879 N MILWAUKEE AVE STE 1
CHICAGO, IL
60647-5689

Practice Phone: 312-429-6506
Practice Fax:

1801604012 — ELIZABETH SCHMELZLE
Practice Location Address:

1879 N MILWAUKEE AVE APT 209
CHICAGO, IL
60647-5689

Practice Phone: 612-743-3231
Practice Fax:

1861898835 — FIRST AVAILABLE MEDICAL STAFFING INC
Practice Location Address:

4552 1/2 N BROADWAY ST
CHICAGO, IL
60640-5689

Practice Phone: 773-784-2855
Practice Fax:

1033040357 — J C KANIA DDS PC
Practice Location Address:

2604 W NORTH AVE
CHICAGO, IL
60647-5235

Practice Phone: 773-252-0033
Practice Fax: 773-252-0033

1659148245 — RACHEL KIRKES
Practice Location Address:

2036 N HUMBOLDT BLVD
CHICAGO, IL
60647-3847

Practice Phone: 415-686-3759
Practice Fax:

1356270896 — BRITTANY GARLING-BRACKINS DL
Practice Location Address:

2614 N RICHMOND ST APT 3
CHICAGO, IL
60647-1780

Practice Phone: 312-813-0333
Practice Fax:

Directions to “KINTSUGI GROUP PLLC ” 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.