MEDICARE: SALVA AFZAL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	019037155	IL

General Provider Information

NPI Number	:	1134052343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALVA AFZAL DMD

Provider Business Mailing Address
First Line	:	24138 W WALNUT CIR
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60585-2474
Country	:	US
Telephone Number	:	630-740-9476
Fax Number	:

Provider Business Practice Location Address
First Line	:	24138 W WALNUT CIR
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60585-2474
Country	:	US
Telephone Number	:	630-740-9476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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