MEDICARE: HIROSHI UENO DDS MS 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
2	261QD0000X	Dental Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962169896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIROSHI UENO DDS MS PLLC

Provider Business Mailing Address
First Line	:	916 ELK GROVE TOWN CTR
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3754
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	916 ELK GROVE TOWN CTR
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3754
Country	:	US
Telephone Number	:	314-728-7175
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HIROSHI UENO
Credential	:	DDS MS
Telephone Number	:	314-728-7175

Provider Enumeration Date	:	11/28/2021
Last Update Date	:	05/11/2026

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