Provider Demographics
NPI:1770644635
Name:DUPAGE DENTAL CARE INC
Entity Type:Organization
Organization Name:DUPAGE DENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR DENTIST PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FIRDAUS
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAFRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-665-2147
Mailing Address - Street 1:206 N GARY AVENUE
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-1834
Mailing Address - Country:US
Mailing Address - Phone:630-665-2147
Mailing Address - Fax:630-665-6980
Practice Address - Street 1:206 N GARY AVENUE
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-1834
Practice Address - Country:US
Practice Address - Phone:630-665-2147
Practice Address - Fax:630-665-6980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty