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

Foster Avenue Dental Clinic PC

Organization Dentist · NPI 1205133527

Foster Avenue Dental Clinic PC is a Dentist in Des Plaines, Illinois. Licensed in Illinois. Registered with an NPI since 2011.

Licensed in
IL
In the registry since
2011
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

1400 E Golf Rd Ste 125
Des Plaines, IL 60016-1236
Phone: (847) 827-7990
Fax: (847) 827-7852
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019019206 (IL)

Record details

NPI number1205133527
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gregory Tietzer — Owner · (773) 463-8860
NPI enumeratedFebruary 23, 2011
Last updated in NPPESFebruary 23, 2011
Mailing address3318 W Foster Ave, Chicago, IL 60625-4813

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