Provider Demographics
NPI:1407010531
Name:DENTAL DREAMS, LLC
Entity Type:Organization
Organization Name:DENTAL DREAMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMEERA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:312-274-9962
Mailing Address - Street 1:700 ESSEX ST
Mailing Address - Street 2:UNIT 1A1
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-4396
Mailing Address - Country:US
Mailing Address - Phone:978-683-2200
Mailing Address - Fax:978-683-2211
Practice Address - Street 1:700 ESSEX ST
Practice Address - Street 2:UNIT 1A1
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-4396
Practice Address - Country:US
Practice Address - Phone:978-683-2200
Practice Address - Fax:978-683-2211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty