Provider Demographics
NPI:1003246927
Name:ALL KIDS DENTAL CENTER, LLC
Entity Type:Organization
Organization Name:ALL KIDS DENTAL CENTER, LLC
Other - Org Name:DOING BUSINESS AS: ALL FAMILY DENTAL & BRACES
Other - Org Type:Other Name
Authorized Official - Title/Position:CO-OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:VANNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-375-0325
Mailing Address - Street 1:4849 N MILWAUKEE AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2169
Mailing Address - Country:US
Mailing Address - Phone:773-302-0385
Mailing Address - Fax:
Practice Address - Street 1:1812 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-2039
Practice Address - Country:US
Practice Address - Phone:708-498-4410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty