Provider Demographics
NPI:1689867327
Name:KUMAR, AMIT (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:KUMAR
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 1:250 CENTER DR
Mailing Address - Street 2:STE 202
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1582
Mailing Address - Country:US
Mailing Address - Phone:847-247-1700
Mailing Address - Fax:847-810-0385
Practice Address - Street 1:250 CENTER DR
Practice Address - Street 2:STE 202
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1582
Practice Address - Country:US
Practice Address - Phone:847-247-1700
Practice Address - Fax:847-810-0385
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19-025085122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist