PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC
NPI 1386098390
Dentist - Periodontics in Chicago, IL

Q: What is Periodontal Medicine And Surgical Specialists, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Active since April 15, 2016

1009 W WEBSTER AVE, CHICAGO, IL 60614(630) 627-3930 Get Directions Write a Review

NPPES record last updated: December 23, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Periodontal Medicine And Surgical Specialists, Llc NPPES

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

PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC (NPI 1386098390), doing business as Periodontal Medicine And Surgical Specialists, Ltd, is a healthcare organization registered as a periodontics in Chicago, Illinois and active in the NPI registry since April 2016. The organization lists George Mandelaris, President, as its authorized official.

NPPES Registry Identity

NPI1386098390

Entity TypeOrganization

Primary Taxonomy1223P0300X

Legal Business NamePERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC

Location Address1009 W WEBSTER AVEChicago, IL 60614-3502

Mailing Address1s224 Summit Ave, Suite 205Oakbrook Terrace, IL 60181-3983 · (630) 627-3930

Phone(630) 627-3930

Organization SubpartNo

Authorized OfficialGeorge MandelarisPresident · (630) 627-3930

Enumeration DateApril 15, 2016

Last NPPES UpdateDecember 23, 2016

✔ NPI 1386098390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

Licenses✔ Licensed in IL · 021001938✔ Licensed in IL · 021002676

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 021002351 (IL)

Also ListedClinic/Center · DentalTaxonomy 261QD0000X

1009 W WEBSTER AVE, Chicago, IL 60614

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Other Names 1

Former Legal Business NamePeriodontal Medicine And Surgical Specialists, Ltd

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

BRIAN SHAH, DDS, MD, PC

Dentist (Oral and Maxillofacial Surgery)

1009 W WEBSTER AVE
CHICAGO, IL 60614

Cook County (872) 829-3280

COLBY JAMES AESTHETIC DENTISTRY PLLC

Clinic/Center (Dental)

1009 W WEBSTER AVE
CHICAGO, IL 60614

Cook County (312) 858-7067

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 Periodontal Medicine And Surgical Specialists, LLC's NPI number?

The NPI number for Periodontal Medicine And Surgical Specialists, LLC is 1386098390. It was assigned to this organization in the NPPES registry on April 15, 2016. The provider was formerly known as Periodontal Medicine And Surgical Specialists, Ltd.

Where is Periodontal Medicine And Surgical Specialists, LLC located?

Periodontal Medicine And Surgical Specialists, LLC is located at 1009 W Webster Ave, Chicago, IL 60614. The listed phone number is (630) 627-3930.

What is Periodontal Medicine And Surgical Specialists, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Periodontal Medicine And Surgical Specialists, LLC was last updated on December 23, 2016. 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.