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General NPI Number Information
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NPI Number | 1891916003
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Entity Type | Individual
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Provider Name | VASSOS B. HAJIHARIS DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 4435 W 95TH STREET
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City | OAKLAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 313-499-4775
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Fax | 708-423-8552
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Provider Business Mailing Address
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Address Line | 7625 W 15TH STREET
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City | TINLEY PARK
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State | FL
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Zip | 60477
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Country | US
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Telephone | 708-429-4770
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Fax | 708-429-9685
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2901018486
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 4301086539
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 019013377
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License Number State | IL
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