Healthcare Provider Details

I. General information

NPI: 1346181146
Provider Name (Legal Business Name): FA DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1863 HICKS RD
ROLLING MEADOWS IL
60008-1215
US

IV. Provider business mailing address

1863 HICKS RD
ROLLING MEADOWS IL
60008-1215
US

V. Phone/Fax

Practice location:
  • Phone: 847-991-3009
  • Fax:
Mailing address:
  • Phone: 847-991-3009
  • 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: DR. FAKHRA AHMAD
Title or Position: DENTIST
Credential: DMD
Phone: 224-800-2955