Provider Demographics
NPI:1710662838
Name:AJDC PLLC
Entity Type:Organization
Organization Name:AJDC PLLC
Other - Org Name:AJ DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:SAIM
Authorized Official - Last Name:JABBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-841-1195
Mailing Address - Street 1:1533 ELLINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4553
Mailing Address - Country:US
Mailing Address - Phone:847-582-3352
Mailing Address - Fax:847-582-3362
Practice Address - Street 1:1533 ELLINWOOD AVE
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4553
Practice Address - Country:US
Practice Address - Phone:773-841-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty