Provider Demographics
NPI:1710513478
Name:ETHICADENT
Entity Type:Organization
Organization Name:ETHICADENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HELIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:YILDIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:773-657-3075
Mailing Address - Street 1:6418 W BELMONT AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4099
Mailing Address - Country:US
Mailing Address - Phone:773-657-3075
Mailing Address - Fax:
Practice Address - Street 1:6418 W BELMONT AVE STE 101
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4099
Practice Address - Country:US
Practice Address - Phone:773-657-3075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental