Provider Demographics
NPI:1114427358
Name:RAZI ORTHODONTICS LTD
Entity Type:Organization
Organization Name:RAZI ORTHODONTICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:414-807-0074
Mailing Address - Street 1:2212 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-9140
Mailing Address - Country:US
Mailing Address - Phone:630-614-1162
Mailing Address - Fax:
Practice Address - Street 1:2212 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-9140
Practice Address - Country:US
Practice Address - Phone:630-614-1162
Practice Address - Fax:630-633-8222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty