Provider Demographics
NPI:1851084214
Name:EVOLVE DENTISTRY P.C.
Entity Type:Organization
Organization Name:EVOLVE DENTISTRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNED ALI KHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:872-806-9602
Mailing Address - Street 1:6160 S CASS AVE STE E
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2685
Mailing Address - Country:US
Mailing Address - Phone:630-812-7755
Mailing Address - Fax:630-912-7572
Practice Address - Street 1:6160 S CASS AVE STE E
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2685
Practice Address - Country:US
Practice Address - Phone:630-812-7755
Practice Address - Fax:630-912-7572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental