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General NPI Number Information
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NPI Number | 1790619898
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Entity Type | Individual
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Provider Name | MUSTAFA A AL AADHAMI DMD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 5821 DEMPSTER ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-3028
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Country | US
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Telephone | 847-581-1942
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Fax |
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Provider Business Mailing Address
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Address Line | 9434 BAY COLONY DR APT 2W
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City | DES PLAINES
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State | IL
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Zip | 60016-3640
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Country | US
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Telephone | 253-886-0866
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019037171
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License Number State | IL
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