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General NPI Number Information
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NPI Number | 1427534429
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Entity Type | Individual
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Provider Name | SAMIM TARAJI DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 1328 N MILWAUKEE AVE STE 1
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City | CHICAGO
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State | IL
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Zip | 60622-9148
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Country | US
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Telephone | 773-455-4776
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Fax | 312-547-1328
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Provider Business Mailing Address
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Address Line | 1328 N MILWAUKEE AVE STE 1
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City | CHICAGO
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State | IL
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Zip | 60622-9148
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Country | US
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Telephone | 773-455-4776
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Fax | 312-547-1328
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1001942
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.031646
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License Number State | IL
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