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FULLERTON DENTAL ISLAND LLC
NPI 1265285167
Dentist - General Practice in Chicago, IL

Active since April 09, 2024
5205 W FULLERTON AVE, CHICAGO, IL 60639(312) 709-1722 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fullerton Dental Island Llc NPPES

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

FULLERTON DENTAL ISLAND LLC (NPI 1265285167) is a healthcare organization registered as a general practice in Chicago, Illinois and active in the NPI registry since April 2024. The organization lists Wisam Musa, Owner, as its authorized official.

NPPES Registry Identity

NPI1265285167
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameFULLERTON DENTAL ISLAND LLC
Location Address5205 W FULLERTON AVEChicago, IL 60639-1401
Mailing Address5836 W 100th PlOak Lawn, IL 60453-3774 · (312) 709-1722
Phone(312) 709-1722
Organization SubpartNo
Authorized OfficialWisam MusaOwner · (312) 709-1722
Enumeration DateApril 9, 2024
NPPES CertifiedApril 9, 2024
✔ NPI 1265285167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
5205 W FULLERTON AVE, Chicago, IL 60639
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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 Fullerton Dental Island LLC's NPI number?

The NPI number for Fullerton Dental Island LLC is 1265285167. It was assigned to this organization in the NPPES registry on April 9, 2024.

Where is Fullerton Dental Island LLC located?

Fullerton Dental Island LLC is located at 5205 W Fullerton Ave, Chicago, IL 60639. The listed phone number is (312) 709-1722.

What is Fullerton Dental Island LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Fullerton Dental Island LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Fullerton Dental Island LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fullerton Dental Island LLC was last updated on April 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.