Provider Demographics
NPI:1164190674
Name:JUAN S. ABADIA DDS P.C.
Entity Type:Organization
Organization Name:JUAN S. ABADIA DDS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:SEBASTIAN
Authorized Official - Last Name:ABADIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-310-7000
Mailing Address - Street 1:750 W HINTZ RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5501
Mailing Address - Country:US
Mailing Address - Phone:847-310-7000
Mailing Address - Fax:847-610-7711
Practice Address - Street 1:750 W HINTZ RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5501
Practice Address - Country:US
Practice Address - Phone:847-310-7000
Practice Address - Fax:847-610-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental