Healthcare Provider Details

I. General information

NPI: 1053822817
Provider Name (Legal Business Name): ANDLEEB QURESHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8276 MAYFIELD RD
CHESTERLAND OH
44026-2518
US

IV. Provider business mailing address

8276 MAYFIELD RD
CHESTERLAND OH
44026-2518
US

V. Phone/Fax

Practice location:
  • Phone: 440-491-4001
  • Fax:
Mailing address:
  • Phone: 440-491-4001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.025367
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberRES.003907
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: