OrganizationActive
Heritage Dental
NPI 1356490700 · General Practice Dentistry · Antioch, IL
Provider details
- NPI number
- 1356490700
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Kenneth Jazdzewski, Officer of Corporation(847) 395-1461
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
800 Main St
Antioch, IL 60002-1542
Phone: (847) 395-1461
Fax: (847) 395-9255
Street-level locationGet directions
Mailing address
800 Main St
Antioch, IL 60002-1542
Registry dates
- Enumerated
- 2007-01-08
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.