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

Old Orchard Periodontics & Implant Dentistry Ltd

Organization Periodontics · NPI 1821139171

Old Orchard Periodontics & Implant Dentistry Ltd provides Periodontics in Skokie, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4905 Old Orchard Shopping Ctr Ste 310
Skokie, IL 60077-1425
Phone: (847) 982-0640
Fax: (847) 982-0644
Show map & directions

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

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 021001143 (IL)

Record details

NPI number1821139171
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Barack — Owner · (847) 982-0640
NPI enumeratedFebruary 9, 2007
Last updated in NPPESJuly 29, 2026
Certification dateJuly 29, 2026
Mailing address4905 Old Orchard Ctr Ste 310, Skokie, IL 60077-4740

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