Provider Demographics
NPI:1518039718
Name:DOHSE, ANTHONY (DDS)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:DOHSE
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 1:533 W NORTH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2100
Mailing Address - Country:US
Mailing Address - Phone:630-941-3400
Mailing Address - Fax:630-941-3421
Practice Address - Street 1:533 W NORTH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2100
Practice Address - Country:US
Practice Address - Phone:630-941-3400
Practice Address - Fax:630-941-3421
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0217521223S0112X
IL019.0217521223S0112X
IL021.0017141223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019-021752Medicaid
ILU52940Medicare UPIN
K51323Medicare UPIN
IL019-021752Medicaid