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General NPI Number Information
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NPI Number | 1538896667
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Entity Type | Individual
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Provider Name | UMAR PASHA DDS
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Gender | Male
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Dates
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Enumeration Date | 08/08/2022
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 3540 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60657-1314
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Country | US
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Telephone | 708-740-5972
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Fax |
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Provider Business Mailing Address
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Address Line | 1074 MAPLE LN
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-2306
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Country | US
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Telephone | 516-524-9361
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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 | 019033933
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License Number State | IL
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