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NPI Code Detail

MEDICARE: ALALEH DOWLATSHAHI DDS

MEDICARE: ALALEH DOWLATSHAHI 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
1122300000XDentist019.027868IL

General Provider Information

NPI Number : 1932349248
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALALEH DOWLATSHAHI DDS
Provider Business Mailing Address
First Line : 1525 S SANGAMON STREET
Second Line : APT 617
City : CHICAGO
State : IL
Zip : 60608-2241
Country : US
Telephone Number : 312-388-0109
Fax Number :
Provider Business Practice Location Address
First Line : 3210 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-3325
Country : US
Telephone Number : 312-274-0308
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2009
Last Update Date : 02/26/2009

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Directions to “ ALALEH DOWLATSHAHI DDS” Practice Location

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