Galleria Dental
Dentist, General Practice in Mundelein, IL. Organization (NPI-2).
Details
- NPI
- 1124428099
- Entity type
- Organization (NPI-2)
- Legal business name
- Galleria Dental
- Organization subpart
- Yes
- Enumeration date
- Aug 28, 2014
- Certification date
- Dec 10, 2020
- Last updated
- Dec 10, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
1535 S Lake StMundelein, IL 60060-4210
Phone 847-566-1900 · Fax 847-566-1904
Mailing address
1730 Park St Ste 106Naperville, IL 60563-2609
Phone 847-566-1900 · Fax 847-566-1904
Authorized official
Sohail S Shafi
Manager
6308423705
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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