Provider Demographics
NPI:1346647443
Name:SCHAUMBURG DENTAL CARE, PC/A-ONE DENTAL
Entity Type:Organization
Organization Name:SCHAUMBURG DENTAL CARE, PC/A-ONE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIAST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYANK
Authorized Official - Middle Name:R
Authorized Official - Last Name:ADATIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-769-4132
Mailing Address - Street 1:2071 IRVING PARK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-3159
Mailing Address - Country:US
Mailing Address - Phone:847-310-0100
Mailing Address - Fax:847-220-9218
Practice Address - Street 1:2071 IRVING PARK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-3159
Practice Address - Country:US
Practice Address - Phone:847-310-0100
Practice Address - Fax:847-220-9218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019017342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty