Provider Demographics
NPI:1023827029
Name:UNITED DENTAL SURGERY INC
Entity type:Organization
Organization Name:UNITED DENTAL SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KORDI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:847-668-9616
Mailing Address - Street 1:3100 LEXINGTON LN APT 112
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5936
Mailing Address - Country:US
Mailing Address - Phone:847-668-9616
Mailing Address - Fax:
Practice Address - Street 1:8501 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-3504
Practice Address - Country:US
Practice Address - Phone:847-668-9616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental