Provider Demographics
NPI:1063667814
Name:AARON OHEMENG,DDS,PC
Entity Type:Organization
Organization Name:AARON OHEMENG,DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:N
Authorized Official - Last Name:OHEMENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-848-6166
Mailing Address - Street 1:6429 NORTH AVE
Mailing Address - Street 2:SUITE #104
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1028
Mailing Address - Country:US
Mailing Address - Phone:708-848-6166
Mailing Address - Fax:708-848-6123
Practice Address - Street 1:6429 NORTH AVE
Practice Address - Street 2:SUITE #104
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1028
Practice Address - Country:US
Practice Address - Phone:708-848-6166
Practice Address - Fax:708-848-6123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190218081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty