Provider Demographics
NPI:1427927979
Name:CLASSIC SMILES LLC
Entity type:Organization
Organization Name:CLASSIC SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LENA
Authorized Official - Middle Name:JUDITH
Authorized Official - Last Name:CASIMIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:224-277-3309
Mailing Address - Street 1:850 S WABASH AVE STE 290
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3642
Mailing Address - Country:US
Mailing Address - Phone:312-922-3411
Mailing Address - Fax:
Practice Address - Street 1:850 S WABASH AVE STE 290
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3642
Practice Address - Country:US
Practice Address - Phone:312-922-3411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty