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

Maxime Bouvagnet, DMD

Individual provider Dentist · NPI 1295428803

Maxime Bouvagnet, DMD is a Dentist in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2023
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

4641 W Diversey Ave
Chicago, IL 60639-1828
Phone: (773) 692-4147
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019034281 (IL)

Record details

NPI number1295428803
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedMay 30, 2023
Last updated in NPPESMay 30, 2023
Certification dateMay 30, 2023
Mailing address1541 W Wellington Ave # G, Chicago, IL 60657-4014

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