Healthcare Provider Details

I. General information

NPI: 1861355919
Provider Name (Legal Business Name): M&A DENTAL CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 16TH ST STE 19
OAK BROOK IL
60523-1302
US

IV. Provider business mailing address

1600 16TH ST STE 19
OAK BROOK IL
60523-1302
US

V. Phone/Fax

Practice location:
  • Phone: 630-822-9706
  • Fax:
Mailing address:
  • Phone: 630-822-9706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: AOUN KHAN
Title or Position: DENTIST
Credential: DMD
Phone: 708-655-0312