Healthcare Provider Details

I. General information

NPI: 1265314512
Provider Name (Legal Business Name): XHEJS LAME DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4133 MEXICO RD
SAINT PETERS MO
63376-6410
US

IV. Provider business mailing address

6461 W WARNER AVE
CHICAGO IL
60634-6222
US

V. Phone/Fax

Practice location:
  • Phone: 636-447-6060
  • Fax:
Mailing address:
  • Phone: 773-370-2998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019036153
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2025029834
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: