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Organization
SECURE DENTAL LLC
Active
Organization
SECURE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAZISH HASAN JAFRI DDS (OWNER DENTIST)
(773) 427-1000
Entity
Organization
Contact information
Practice address
5621 W MONTROSE AVE, CHICAGO, IL 60634-1830
(733) 427-1000
Mailing address
502 RIVERSIDE DR, EAST PEORIA, IL 61611-2068
(309) 606-5008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/16/2026
Last updated
07/20/2026
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