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General NPI Number Information
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NPI Number | 1790169076
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Entity Type | Individual
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Provider Name | PARTH NANAVATI D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 9201 N ASHLAND AVE
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City | NILES
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State | IL
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Zip | 60714-1305
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Country | US
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Telephone | 847-962-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 9201 N ASHLAND AVE
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City | NILES
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State | IL
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Zip | 60714-1305
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Country | US
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Telephone |
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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 | 019030254
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License Number State | IL
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