Healthcare Provider Details

I. General information

NPI: 1225615719
Provider Name (Legal Business Name): ARASH JAMILPANAH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 N LAKE SHORE DR APT 3D
CHICAGO IL
60613-3457
US

IV. Provider business mailing address

3900 N LAKE SHORE DR APT 3D
CHICAGO IL
60613-3457
US

V. Phone/Fax

Practice location:
  • Phone: 408-775-4140
  • Fax:
Mailing address:
  • Phone: 408-775-4140
  • Fax: 312-312-9689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number019.034520
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: