MEDICARE: DENTAL EXPERTS, LLC

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		IL

General Provider Information

NPI Number	:	1891966883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL EXPERTS, LLC

Provider Business Mailing Address
First Line	:	2240 S CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60804-2411
Country	:	US
Telephone Number	:	708-656-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 S CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60804-2411
Country	:	US
Telephone Number	:	708-656-2222
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	SAMEERA HUSSAIN
Credential	:	DMD
Telephone Number	:	630-750-1405

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	03/18/2008

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Directions to “DENTAL EXPERTS, LLC ” Practice Location

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