Provider Demographics
NPI:1871750471
Name:UNGER, JOSEPH GREGORY (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GREGORY
Last Name:UNGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-5531
Mailing Address - Country:US
Mailing Address - Phone:773-582-8129
Mailing Address - Fax:773-582-8129
Practice Address - Street 1:4424 W 63RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-5531
Practice Address - Country:US
Practice Address - Phone:773-582-8129
Practice Address - Fax:773-582-8129
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0195771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice