Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Dental Associates of South Ridge, PC

Organization Dentist · NPI 1396292884

Dental Associates of South Ridge, PC provides Dentist services 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 Not confirmed with CMS for 10 years — call before visiting
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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