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MODERN DENTAL ON CLARK STREET
NPI 1265962674
Dentist - General Practice in Chicago, IL

Active since June 18, 2017
744 N CLARK ST, CHICAGO, IL 60654(773) 489-5700 Get Directions Write a Review

NPPES record last updated: June 18, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Modern Dental On Clark Street NPPES

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

MODERN DENTAL ON CLARK STREET (NPI 1265962674) is a healthcare organization registered as a general practice in Chicago, Illinois and active in the NPI registry since June 2017. The organization lists Phillip Palella, Owner, as its authorized official.

NPPES Registry Identity

NPI1265962674
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMODERN DENTAL ON CLARK STREET
Location Address744 N CLARK STChicago, IL 60654-2525
Mailing Address2037 W Division StChicago, IL 60622-3157
Phone(773) 489-5700
Organization SubpartNo
Authorized OfficialPhillip PalellaOwner · (773) 489-5700
Enumeration DateJune 18, 2017
✔ NPI 1265962674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.
Also ListedClinic/Center · DentalTaxonomy 261QD0000X
Also ListedPreferred Provider OrganizationTaxonomy 305R00000X
744 N CLARK ST, Chicago, IL 60654
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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 Modern Dental On Clark Street's NPI number?

The NPI number for Modern Dental On Clark Street is 1265962674. It was assigned to this organization in the NPPES registry on June 18, 2017.

Where is Modern Dental On Clark Street located?

Modern Dental On Clark Street is located at 744 N Clark St, Chicago, IL 60654. The listed phone number is (773) 489-5700.

What is Modern Dental On Clark Street's specialty?

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

When was this NPI record last updated?

The NPPES record for Modern Dental On Clark Street was last updated on June 18, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.