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INDEPENDENCE FAMILY DENTAL
NPI 1164406138
Dentist in Chicago, IL

Active since December 02, 2005
4703 W LAWRENCE AVE, CHICAGO, IL 60630(773) 205-9900(773) 205-9970 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Independence Family Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INDEPENDENCE FAMILY DENTAL (NPI 1164406138) is a healthcare organization registered as a dentist in Chicago, Illinois and active in the NPI registry since December 2005. The organization lists Emad E Azab, Dentist, as its authorized official.

NPPES Registry Identity

NPI1164406138
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameINDEPENDENCE FAMILY DENTAL
Location Address4703 W LAWRENCE AVEChicago, IL 60630-1722
Mailing Address4703 W Lawrence AveChicago, IL 60630-1722 · (773) 205-9900 · Fax (773) 205-9970
Phone(773) 205-9900
Fax(773) 205-9970
Organization SubpartNo
Authorized OfficialEmad E AzabDentist · (773) 205-9900
Enumeration DateDecember 2, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1164406138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
4703 W LAWRENCE AVE, Chicago, IL 60630
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Other Identifiers 1

Medicaid101611IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLUE STAR DENTAL INC
Dentist (General Practice)
4703 W LAWRENCE AVE
CHICAGO, IL 60630
Cook County (773) 698-5773
DR. EMAD E AZAB D.D.S
Dentist
4703 W LAWRENCE AVE
CHICAGO, IL 60630
Cook County (773) 205-9900
EMERGENCY DENTIST OF CHICAGO PLLC
Clinic/Center (Dental)
4703 W LAWRENCE AVE
CHICAGO, IL 60630
Cook County (773) 461-1973

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Independence Family Dental's NPI number?

The NPI number for Independence Family Dental is 1164406138. It was assigned to this organization in the NPPES registry on December 2, 2005.

Where is Independence Family Dental located?

Independence Family Dental is located at 4703 W Lawrence Ave, Chicago, IL 60630. The listed phone number is (773) 205-9900.

What is Independence Family Dental's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Independence Family Dental was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.