Provider Demographics
NPI:1821729799
Name:TADROS, IRINY GADOON (DMD)
Entity Type:Individual
Prefix:DR
First Name:IRINY
Middle Name:GADOON
Last Name:TADROS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 S BRADFORD DR
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-8805
Mailing Address - Country:US
Mailing Address - Phone:630-923-1708
Mailing Address - Fax:
Practice Address - Street 1:2205 S BRADFORD DR
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-8805
Practice Address - Country:US
Practice Address - Phone:630-923-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0336921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice