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General NPI Number Information
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NPI Number | 1851706964
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Entity Type | Individual
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Provider Name | PREETI IYER DAS D.D.S
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Gender | Female
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 111 W. JACKSON STE 1410
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City | CHICAGO
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State | IL
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Zip | 60604
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Country | US
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Telephone | 312-939-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 2705 N ARTESIAN AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60647
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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 | 2901021220
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.031798
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License Number State | IL
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