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General NPI Number Information
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NPI Number | 1457140816
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Entity Type | Organization
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Legal Business Name | DR. JOSEPH FAMILY DENTAL PLLC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 282 MCHENRY RD
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City | WHEELING
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State | IL
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Zip | 60090-3202
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Country | US
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Telephone | 804-300-8553
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Fax |
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Provider Business Mailing Address
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Address Line | 9433 CHURCHILL DR
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City | HICKORY HILLS
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State | IL
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Zip | 60457-7203
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Country | US
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Telephone | 804-300-8553
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HISHAM JOSEPH GHARIB
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Credential | DDS, CAGS
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Telephone | 804-300-8553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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