Provider Demographics
NPI:1689436453
Name:BLUE LEAF DENTAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:BLUE LEAF DENTAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-839-3310
Mailing Address - Street 1:18 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9547
Mailing Address - Country:US
Mailing Address - Phone:909-839-3310
Mailing Address - Fax:
Practice Address - Street 1:501 W GOLF RD STE B
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195-3504
Practice Address - Country:US
Practice Address - Phone:909-839-3310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental