Healthcare Provider Details

I. General information

NPI: 1356701007
Provider Name (Legal Business Name): ASHRAF MOHAMED NASER BDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2016
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1999 75TH ST STE 101
WOODRIDGE IL
60517-2666
US

IV. Provider business mailing address

8528 EVERGREEN LN
DARIEN IL
60561-8415
US

V. Phone/Fax

Practice location:
  • Phone: 331-326-4010
  • Fax: 331-326-4025
Mailing address:
  • Phone: 781-472-0511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019031426
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: