Provider Demographics
NPI:1326351636
Name:PARAGAS, CARLY RAE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLY
Middle Name:RAE
Last Name:PARAGAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6154 159TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-2906
Mailing Address - Country:US
Mailing Address - Phone:708-687-0100
Mailing Address - Fax:
Practice Address - Street 1:6154 159TH ST
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-2906
Practice Address - Country:US
Practice Address - Phone:708-687-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190282631223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice