Healthcare Provider Details

I. General information

NPI: 1730633975
Provider Name (Legal Business Name): FATIMA NASREEN SAEED D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E ROOSEVELT RD
LOMBARD IL
60148-4561
US

IV. Provider business mailing address

1400 SANTA RITA RD STE A
PLEASANTON CA
94566-5663
US

V. Phone/Fax

Practice location:
  • Phone: 630-843-0412
  • Fax:
Mailing address:
  • Phone: 630-843-0412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.030907
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number019.030907
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: