MEDICARE: BLOSSOM ORTHODONTICS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1851225700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOSSOM ORTHODONTICS

Provider Business Mailing Address
First Line	:	7130 DEMPSTER ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2053
Country	:	US
Telephone Number	:	224-601-6012
Fax Number	:	224-601-6019

Provider Business Practice Location Address
First Line	:	7130 DEMPSTER ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2053
Country	:	US
Telephone Number	:	224-601-6012
Fax Number	:	224-601-6019

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	SHERRY DEOL
Credential	:	DMD
Telephone Number	:	224-601-6012

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

Similar Medicare Providers

1073644605 — DR. RASHMIKA B PATEL D.D.S.
Practice Location Address:

7140 DEMPSTER ST
MORTON GROVE, IL
60053-2053

Practice Phone: 847-967-8999
Practice Fax: 847-965-8991

1265978423 — MORTON GROVE DENTISTRY LTD
Practice Location Address:

7140 DEMPSTER ST
MORTON GROVE, IL
60053-2053

Practice Phone: 847-967-8999
Practice Fax:

1891308029 — MAGNOLIA GROVE CITY LLC
Practice Location Address:

2053 STRINGTOWN RD
GROVE CITY, OH
43123-2930

Practice Phone: 614-636-4081
Practice Fax:

1972393239 — SARA HAREN DDS
Practice Location Address:

2053 STRINGTOWN RD
GROVE CITY, OH
43123-2930

Practice Phone: 614-801-0079
Practice Fax:

1922985530 — AIMEE THOMPSON
Practice Location Address:

2053 GROVE SUMMERS RD
NEW MILTON, WV
26411-6118

Practice Phone: 304-695-0473
Practice Fax:

1477487262 — CARE BRIDGE LLC
Practice Location Address:

9219 BELLEFORTE AVE
MORTON GROVE, IL
60053-2042

Practice Phone: 929-494-1034
Practice Fax:

Directions to “BLOSSOM ORTHODONTICS ” 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.