OrganizationActive
Modern Dental of Logan Square LLC
NPI 1639625437 · General Practice Dentistry · Chicago, IL
Modern Dental of Logan Square LLC is a General Practice Dentistry organization in Chicago, IL (NPI 1639625437).
Provider details
- NPI number
- 1639625437
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Phillip Palella, Owner(773) 489-5700
- License
- 019026403 (IL)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
2645 N Milwaukee
Chicago, IL 60647
Phone: (773) 717-5509
Street-level locationGet directions
Mailing address
2037 W Division
Chicago, IL 60622
Registry dates
- Enumerated
- 2016-08-31
- Last updated
- 2016-08-31
Frequently asked questions
- What is Modern Dental of Logan Square LLC's NPI number?
- Modern Dental of Logan Square LLC's National Provider Identifier (NPI) is 1639625437, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Modern Dental of Logan Square LLC?
- Modern Dental of Logan Square LLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Modern Dental of Logan Square LLC located?
- Modern Dental of Logan Square LLC's practice location on file with NPPES is 2645 N Milwaukee, Chicago, IL 60647.
- What is Modern Dental of Logan Square LLC's phone number?
- The practice phone number listed in the NPPES registry for Modern Dental of Logan Square LLC is (773) 717-5509.
- Who is the authorized official for Modern Dental of Logan Square LLC?
- The authorized official listed on Modern Dental of Logan Square LLC's NPPES record is Phillip Palella, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Modern Dental of Logan Square LLC's NPI active?
- Yes — Modern Dental of Logan Square LLC's NPI (1639625437) is active in the NPPES registry as of the last update on 2016-08-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.