Provider Demographics
NPI:1205844354
Name:DUMANIS, ABRAHAM ISAAC (DS,DDS)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:ISAAC
Last Name:DUMANIS
Suffix:
Gender:M
Credentials:DS,DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 WINCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-3300
Mailing Address - Country:US
Mailing Address - Phone:847-341-4204
Mailing Address - Fax:
Practice Address - Street 1:9933 LAWLER AVE STE 501
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4302
Practice Address - Country:US
Practice Address - Phone:847-329-9858
Practice Address - Fax:847-329-9768
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice