Provider Demographics
NPI:1821376260
Name:ROHANISH ENTERPRISES INC
Entity Type:Organization
Organization Name:ROHANISH ENTERPRISES INC
Other - Org Name:STRATFORD SQUARE PERIODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUZER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINWALLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:630-582-3120
Mailing Address - Street 1:1 TIFFANY PT STE 205
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2916
Mailing Address - Country:US
Mailing Address - Phone:630-582-3120
Mailing Address - Fax:630-582-3137
Practice Address - Street 1:1 TIFFANY PT STE 205
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2916
Practice Address - Country:US
Practice Address - Phone:630-582-3120
Practice Address - Fax:630-582-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019023850261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental