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

Independence Family Dental

Organization Dentist · NPI 1164406138

Independence Family Dental is a Dentist in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005

Practice location Address checks out

4703 W Lawrence Ave
Chicago, IL 60630-1722
Phone: (773) 205-9900
Fax: (773) 205-9970
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X (IL)

Record details

NPI number1164406138
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Emad Azab — Dentist · (773) 205-9900
NPI enumeratedDecember 2, 2005
Last updated in NPPESAugust 22, 2020
Mailing address4703 W Lawrence Ave, Chicago, IL 60630-1722

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