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General NPI Number Information
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NPI Number | 1366173031
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Entity Type | Individual
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Provider Name | RAYA DAWOUD DMD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 3346 W LAWRENCE AVE
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City | CHICAGO
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State | IL
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Zip | 60625-5212
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Country | US
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Telephone | 773-739-2219
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Fax |
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Provider Business Mailing Address
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Address Line | 900 W FULLERTON AVE APT 5A
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City | CHICAGO
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State | IL
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Zip | 60614-2442
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Country | US
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Telephone | 331-452-7056
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.033826
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License Number State | IL
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