Provider Demographics
NPI:1417727827
Name:WAIA, DALIA (DDS, MS)
Entity Type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:WAIA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S JEFFERSON ST UNIT 3001
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-3728
Mailing Address - Country:US
Mailing Address - Phone:312-590-9781
Mailing Address - Fax:
Practice Address - Street 1:1300 E WOODFIELD RD STE 110
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4908
Practice Address - Country:US
Practice Address - Phone:847-230-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0347011223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics