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General NPI Number Information
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NPI Number | 1841117736
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Entity Type | Organization
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Legal Business Name | SMILE HAUS DENTAL STUDIO LLC
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 10108 MONDORF ST STE C&D
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City | DYER
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State | IN
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Zip | 46311-0059
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Country | US
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Telephone | 219-377-6453
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Fax | 219-207-8005
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Provider Business Mailing Address
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Address Line | 10108 MONDORF ST STE C&D
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City | DYER
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State | IN
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Zip | 46311-0059
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Country | US
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Telephone | 219-377-6453
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Fax | 219-207-8005
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. SIMON ABU-AITA
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Credential | DMD
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Telephone | 219-805-9914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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