Provider Demographics
NPI:1407979644
Name:J. P. YOSEPH D.D.S. P.C.
Entity Type:Organization
Organization Name:J. P. YOSEPH D.D.S. P.C.
Other - Org Name:OPTIMA FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOSEPH-ANHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-725-6606
Mailing Address - Street 1:4956 W IRVING PARK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2640
Mailing Address - Country:US
Mailing Address - Phone:773-725-6606
Mailing Address - Fax:773-725-6656
Practice Address - Street 1:4956 W IRVING PARK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2640
Practice Address - Country:US
Practice Address - Phone:773-725-6606
Practice Address - Fax:773-725-6656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty