Provider Demographics
NPI:1093827669
Name:SMILE PRO STUDIO
Entity Type:Organization
Organization Name:SMILE PRO STUDIO
Other - Org Name:ARLINGTON HEIGHTS PROFESSIONAL DENTAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHAND
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOMORRODIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:847-437-3533
Mailing Address - Street 1:1701 E WOODFIELD ROAD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-437-3533
Mailing Address - Fax:847-437-0310
Practice Address - Street 1:1701 E WOODFIELD ROAD
Practice Address - Street 2:SUITE 510
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-437-3533
Practice Address - Fax:847-437-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0122571223G0001X, 1223P0700X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty