OrganizationActive
Jefferson Park Family Dental LLC
NPI 1417528589 · General Practice Dentistry · Chicago, IL
Jefferson Park Family Dental LLC is a General Practice Dentistry organization in Chicago, IL (NPI 1417528589).
Provider details
- NPI number
- 1417528589
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Robert Stites, Insurance Coordinator-Decision One(630) 869-5857
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
4452 N Central Ave
Chicago, IL 60630-3302
Phone: (773) 777-4800
Fax: (773) 777-4918
Street-level locationGet directions
Mailing address
4452 N Central Ave
Chicago, IL 60630-3302
Registry dates
- Enumerated
- 2021-07-08
- Last updated
- 2023-01-13
- Certified
- 2023-01-13
Frequently asked questions
- What is Jefferson Park Family Dental LLC's NPI number?
- Jefferson Park Family Dental LLC's National Provider Identifier (NPI) is 1417528589, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jefferson Park Family Dental LLC?
- Jefferson Park Family Dental LLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Jefferson Park Family Dental LLC located?
- Jefferson Park Family Dental LLC's practice location on file with NPPES is 4452 N Central Ave, Chicago, IL 60630-3302.
- What is Jefferson Park Family Dental LLC's phone number?
- The practice phone number listed in the NPPES registry for Jefferson Park Family Dental LLC is (773) 777-4800.
- Who is the authorized official for Jefferson Park Family Dental LLC?
- The authorized official listed on Jefferson Park Family Dental LLC's NPPES record is Robert Stites, Insurance Coordinator-Decision One. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jefferson Park Family Dental LLC's NPI active?
- Yes — Jefferson Park Family Dental LLC's NPI (1417528589) is active in the NPPES registry as of the last update on 2023-01-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.