MEDICARE: 95TH DENTAL CARE PC

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

General Provider Information

NPI Number	:	1821973298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	95TH DENTAL CARE PC

Provider Business Mailing Address
First Line	:	12151 S 73RD AVE
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1411
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3929 W 95TH ST
Second Line	:
City	:	EVERGREEN PARK
State	:	IL
Zip	:	60805-1903
Country	:	US
Telephone Number	:	708-777-3929
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	ALEXANDER ALEMIS
Credential	:
Telephone Number	:	773-251-7573

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	08/06/2025

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