Provider Demographics
NPI:1548582067
Name:EL KHATIB, ILHAM TALIB (BDS)
Entity Type:Individual
Prefix:DR
First Name:ILHAM
Middle Name:TALIB
Last Name:EL KHATIB
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 WESTGATE ST
Mailing Address - Street 2:APT.66
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4639
Mailing Address - Country:US
Mailing Address - Phone:319-330-5713
Mailing Address - Fax:
Practice Address - Street 1:801 NEWTON RD.
Practice Address - Street 2:DENTAL SCIENCE BUILDING
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-335-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30286122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist