Provider Demographics
NPI:1891916003
Name:HAJIHARIS, VASSOS B (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:VASSOS
Middle Name:B
Last Name:HAJIHARIS
Suffix:
Gender:M
Credentials:DDS, MD
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Mailing Address - Street 1:7625 W 15TH STREET
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:FL
Mailing Address - Zip Code:60477
Mailing Address - Country:US
Mailing Address - Phone:708-429-4770
Mailing Address - Fax:708-429-9685
Practice Address - Street 1:4435 W 95TH STREET
Practice Address - Street 2:
Practice Address - City:OAKLAWN
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:313-499-4775
Practice Address - Fax:708-423-8552
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI29010184861223S0112X
MI43010865391223S0112X
IL0190133771223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery