Healthcare Provider Details

I. General information

NPI: 1467875534
Provider Name (Legal Business Name): PREETHI MOHAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 S. LINCOLNWAY ST.
NORTH AURORA IL
60542
US

IV. Provider business mailing address

3555 VANILLA GRASS DR
NAPERVILLE IL
60564-8331
US

V. Phone/Fax

Practice location:
  • Phone: 630-859-8660
  • Fax: 630-604-0400
Mailing address:
  • Phone: 630-859-8660
  • Fax: 630-604-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019 029685
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: