Provider Demographics
NPI:1245742378
Name:DISTINCTIVE DENTAL CARE INC.
Entity Type:Organization
Organization Name:DISTINCTIVE DENTAL CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVED
Authorized Official - Middle Name:
Authorized Official - Last Name:BHOJANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-882-2996
Mailing Address - Street 1:1301 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-5013
Mailing Address - Country:US
Mailing Address - Phone:630-882-2996
Mailing Address - Fax:
Practice Address - Street 1:1301 ORCHARD RD
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-5013
Practice Address - Country:US
Practice Address - Phone:630-882-2996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-025465261QD0000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherIRS