Provider Demographics
NPI:1346079951
Name:ALIGN DENTAL GROUP CHICAGO CORP
Entity type:Organization
Organization Name:ALIGN DENTAL GROUP CHICAGO CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD MOEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-999-9637
Mailing Address - Street 1:1730 PARK ST STE 106
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2609
Mailing Address - Country:US
Mailing Address - Phone:630-596-5018
Mailing Address - Fax:630-596-5019
Practice Address - Street 1:3235 W ADDISON ST # 6
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4381
Practice Address - Country:US
Practice Address - Phone:312-226-1537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALIGN DENTAL GROUP CHICAGO CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty