Healthcare Provider Details

I. General information

NPI: 1710496252
Provider Name (Legal Business Name): NAJJAR DENTAL SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7533 CASS AVE STE D
DARIEN IL
60561-4403
US

IV. Provider business mailing address

7533 CASS AVE STE D
DARIEN IL
60561-4403
US

V. Phone/Fax

Practice location:
  • Phone: 630-541-6986
  • Fax:
Mailing address:
  • Phone: 630-541-6986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number019.029535
License Number StateIL

VIII. Authorized Official

Name: DR. ANAS AL NAJJAR
Title or Position: PRESIDENT
Credential: DMD
Phone: 617-671-9272