Provider Demographics
NPI:1689000721
Name:TURABELIDZE, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:TURABELIDZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 N CLARK ST FL 6
Mailing Address - Street 2:DENTAL DREAMS LLC C/O DANIELLE THARP
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-4712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 N CLARK ST FL 6
Practice Address - Street 2:DENTAL DREAMS LLC C/O DANIELLE THARP
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-4712
Practice Address - Country:US
Practice Address - Phone:312-972-3766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program