Healthcare Provider Details
I. General information
NPI: 1538083092
Provider Name (Legal Business Name): SOLOMIYA FURDAS DEKELAITA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2364 S ELMHURST RD
MT PROSPECT IL
60056-5805
US
IV. Provider business mailing address
10357 DEARLOVE RD APT 2F
GLENVIEW IL
60025-3646
US
V. Phone/Fax
- Phone: 847-621-2287
- Fax:
- Phone: 773-226-2245
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 019037342 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: