Provider Demographics
NPI:1477541787
Name:RIBA, HICHAM (DDS)
Entity Type:Individual
Prefix:
First Name:HICHAM
Middle Name:
Last Name:RIBA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8731 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1551
Mailing Address - Country:US
Mailing Address - Phone:219-966-9600
Mailing Address - Fax:219-513-8026
Practice Address - Street 1:8731 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1551
Practice Address - Country:US
Practice Address - Phone:219-966-9600
Practice Address - Fax:219-513-8026
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190243731223G0001X
IN12013461A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice