Provider Demographics
NPI:1902225329
Name:AKHRAS, SALEH MOHAMMAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALEH
Middle Name:MOHAMMAD
Last Name:AKHRAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7124 W 83RD ST
Mailing Address - Street 2:UNIT E
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-4034
Mailing Address - Country:US
Mailing Address - Phone:708-261-0861
Mailing Address - Fax:708-261-0862
Practice Address - Street 1:7124 W 83RD ST UNIT E
Practice Address - Street 2:
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455-4034
Practice Address - Country:US
Practice Address - Phone:708-261-0861
Practice Address - Fax:708-261-0862
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190294241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice