MEDICARE: NAHRAIN DINKHA 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	122300000X	Dentist		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871583245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAHRAIN DINKHA DDS

Provider Business Mailing Address
First Line	:	6625 GOLF RD
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-1322
Country	:	US
Telephone Number	:	847-965-3161
Fax Number	:

Provider Business Practice Location Address
First Line	:	6972 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-3221
Country	:	US
Telephone Number	:	773-262-5898
Fax Number	:	773-262-5897

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/25/2007

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