Provider Demographics
NPI:1598194276
Name:LIPE, DALE M JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:M
Last Name:LIPE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1891 BAY SCOTT CIR
Mailing Address - Street 2:SUITE 113
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1137
Mailing Address - Country:US
Mailing Address - Phone:630-355-0806
Mailing Address - Fax:
Practice Address - Street 1:1891 BAY SCOTT CIR
Practice Address - Street 2:SUITE 113
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1137
Practice Address - Country:US
Practice Address - Phone:630-355-0806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.015444122300000X
IL021.0010391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist