Provider Demographics
NPI:1770646143
Name:ARLINGTON ORTHODONTICS PC
Entity Type:Organization
Organization Name:ARLINGTON ORTHODONTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-255-3020
Mailing Address - Street 1:1420 N ARLINGTON HTS RD
Mailing Address - Street 2:ARLINGTON ORTHODONTICS PC
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004
Mailing Address - Country:US
Mailing Address - Phone:847-255-3020
Mailing Address - Fax:847-255-3036
Practice Address - Street 1:1420 N ARLINGTON HTS RD
Practice Address - Street 2:ARLINGTON ORTHODONTICS PC
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004
Practice Address - Country:US
Practice Address - Phone:847-255-3020
Practice Address - Fax:847-255-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty