Provider Demographics
NPI:1326818667
Name:MUNSTER DENTISTRY LLC
Entity Type:Organization
Organization Name:MUNSTER DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:JADHAV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-247-7216
Mailing Address - Street 1:1S132 SUMMIT AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3931
Mailing Address - Country:US
Mailing Address - Phone:630-247-7216
Mailing Address - Fax:
Practice Address - Street 1:310 RIDGE RD
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1528
Practice Address - Country:US
Practice Address - Phone:630-835-0545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental