Provider Demographics
NPI:1669721502
Name:STAR DENTAL P.C.
Entity type:Organization
Organization Name:STAR DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DHYANVI
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-550-6694
Mailing Address - Street 1:688 BILTMORE DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-2326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6602 BARRINGTON RD
Practice Address - Street 2:SUIT G
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-3900
Practice Address - Country:US
Practice Address - Phone:630-550-6694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0268931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty