Provider Demographics
NPI:1851706964
Name:DAS, PREETI IYER (DDS)
Entity Type:Individual
Prefix:DR
First Name:PREETI
Middle Name:IYER
Last Name:DAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:PREETI
Other - Middle Name:
Other - Last Name:IYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2705 N ARTESIAN AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 W. JACKSON
Practice Address - Street 2:STE 1410
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:312-939-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021220122300000X
IL019.031798122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist