Provider Demographics
NPI:1417012378
Name:ABDULLAI, KIMET (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIMET
Middle Name:
Last Name:ABDULLAI
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 1:17W300 22ND ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4405
Mailing Address - Country:US
Mailing Address - Phone:630-833-2800
Mailing Address - Fax:630-833-2821
Practice Address - Street 1:17W300 22ND ST
Practice Address - Street 2:SUITE 350
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4405
Practice Address - Country:US
Practice Address - Phone:630-833-2800
Practice Address - Fax:630-833-2821
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice