Provider Demographics
NPI:1700132230
Name:LV DENTISTRY, PC
Entity Type:Organization
Organization Name:LV DENTISTRY, PC
Other - Org Name:MOUNT PROSPECT DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BINDU
Authorized Official - Middle Name:
Authorized Official - Last Name:GULATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-803-8883
Mailing Address - Street 1:1753 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-5401
Mailing Address - Country:US
Mailing Address - Phone:847-952-1905
Mailing Address - Fax:847-952-0828
Practice Address - Street 1:1753 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-5401
Practice Address - Country:US
Practice Address - Phone:847-952-1905
Practice Address - Fax:847-952-0828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019025118122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty