Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dental Associates of South Ridge, PC

Organization Dentist · NPI 1396292884

Dental Associates of South Ridge, PC is a Dentist in Gurnee, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6121 Washington St #202
Gurnee, IL 60031-5305
Phone: (847) 625-9897
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019028057 (IL)

Record details

NPI number1396292884
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Priyadarshini Boinpally — President · (847) 625-9897
NPI enumeratedSeptember 1, 2016
Last updated in NPPESSeptember 1, 2016
Mailing address483 Evergreen Dr, Vernon Hills, IL 60061-2907

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