Provider Demographics
NPI:1841978129
Name:SAVAGE, JUAQUAN
Entity type:Individual
Prefix:DR
First Name:JUAQUAN
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 N LAKE SHORE DR APT 1820
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-1524
Mailing Address - Country:US
Mailing Address - Phone:919-951-5223
Mailing Address - Fax:
Practice Address - Street 1:TEMPLE UNIVERSITY HOSPITAL
Practice Address - Street 2:2301 E ALLEGHENY AVE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-282-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014851B1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty