Provider Demographics
NPI:1376683086
Name:MEDHAT DENTAL EXCELLENCE AND ASSOCIATES
Entity Type:Organization
Organization Name:MEDHAT DENTAL EXCELLENCE AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEDHAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-774-3973
Mailing Address - Street 1:6011 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4709
Mailing Address - Country:US
Mailing Address - Phone:773-774-4611
Mailing Address - Fax:773-774-3973
Practice Address - Street 1:6011 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4709
Practice Address - Country:US
Practice Address - Phone:773-774-4611
Practice Address - Fax:773-774-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty