MEDICARE: DANA ABDEDDIN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	019.035395	IL

General Provider Information

NPI Number	:	1083442768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA ABDEDDIN DDS

Provider Business Mailing Address
First Line	:	10849 CRYSTAL SPRINGS LN
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467-3096
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13303 S RIDGELAND AVE
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1815
Country	:	US
Telephone Number	:	708-371-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2024
Last Update Date	:	07/23/2024

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