Provider Demographics
NPI:1619217965
Name:INTEGRITY DENTAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:INTEGRITY DENTAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YINGCHUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-945-7128
Mailing Address - Street 1:276 S WEBER RD UNIT D
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-1549
Mailing Address - Country:US
Mailing Address - Phone:630-312-8280
Mailing Address - Fax:
Practice Address - Street 1:276 S WEBER RD UNIT D
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-1549
Practice Address - Country:US
Practice Address - Phone:630-312-8280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190281811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty