Provider Demographics
NPI:1821220047
Name:DENTAL DREAMS, LLC
Entity Type:Organization
Organization Name:DENTAL DREAMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMEERA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:630-750-1405
Mailing Address - Street 1:1851 CHRISTOPHER COLUMBUS BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2800
Mailing Address - Country:US
Mailing Address - Phone:312-274-0308
Mailing Address - Fax:
Practice Address - Street 1:1851 CHRISTOPHER COLUMBUS BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2800
Practice Address - Country:US
Practice Address - Phone:312-274-0308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0378321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty