Provider Demographics
NPI:1306724125
Name:DEAN DENTAL STUDIO PC
Entity type:Organization
Organization Name:DEAN DENTAL STUDIO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAITALI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSHIYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-373-4467
Mailing Address - Street 1:2020 DEAN ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1665
Mailing Address - Country:US
Mailing Address - Phone:630-443-4545
Mailing Address - Fax:
Practice Address - Street 1:2020 DEAN ST STE C
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1665
Practice Address - Country:US
Practice Address - Phone:630-443-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty