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 provides Dentist services 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 Not confirmed with CMS for 15 years — call before visiting
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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