Provider Demographics
NPI:1235795048
Name:RAED I OWEISI, DMD, PC
Entity Type:Organization
Organization Name:RAED I OWEISI, DMD, PC
Other - Org Name:ACHIEVE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAED
Authorized Official - Middle Name:
Authorized Official - Last Name:OWEISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-737-7365
Mailing Address - Street 1:15856 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-4546
Mailing Address - Country:US
Mailing Address - Phone:708-737-7365
Mailing Address - Fax:708-900-8042
Practice Address - Street 1:15856 WOLF RD
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-4546
Practice Address - Country:US
Practice Address - Phone:708-737-7365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty