Provider Demographics
NPI:1194358960
Name:ESHA DENTAL LLC
Entity Type:Organization
Organization Name:ESHA DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-660-8929
Mailing Address - Street 1:414 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-2535
Mailing Address - Country:US
Mailing Address - Phone:630-660-8929
Mailing Address - Fax:
Practice Address - Street 1:1409 W LAKE ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-1870
Practice Address - Country:US
Practice Address - Phone:630-660-8929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental