MEDICARE: DR. SAMIM TARAJI DMD, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	1001942	WI
2	1223G0001X	General Practice Dentistry	019.031646	IL

General Provider Information

NPI Number	:	1427534429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMIM TARAJI DMD, MS

Provider Business Mailing Address
First Line	:	1328 N MILWAUKEE AVE STE 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-9148
Country	:	US
Telephone Number	:	773-455-4776
Fax Number	:	312-547-1328

Provider Business Practice Location Address
First Line	:	1328 N MILWAUKEE AVE STE 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-9148
Country	:	US
Telephone Number	:	773-455-4776
Fax Number	:	312-547-1328

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

Provider Enumeration Date	:	07/13/2018
Last Update Date	:	02/05/2026

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