Provider Demographics
NPI:1710496252
Name:NAJJAR DENTAL SC
Entity Type:Organization
Organization Name:NAJJAR DENTAL SC
Other - Org Name:NUWAVE DENTAL & ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAS
Authorized Official - Middle Name:
Authorized Official - Last Name:AL NAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-671-9272
Mailing Address - Street 1:7533 CASS AVE STE D
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-4403
Mailing Address - Country:US
Mailing Address - Phone:630-541-6986
Mailing Address - Fax:
Practice Address - Street 1:7533 CASS AVE STE D
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4403
Practice Address - Country:US
Practice Address - Phone:630-541-6986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0295351223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty