Provider Demographics
NPI:1922735158
Name:AQIL, NIDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NIDA
Middle Name:
Last Name:AQIL
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 1:1309 WENTWORTH DR
Mailing Address - Street 2:
Mailing Address - City:VOLO
Mailing Address - State:IL
Mailing Address - Zip Code:60020-3416
Mailing Address - Country:US
Mailing Address - Phone:302-268-0336
Mailing Address - Fax:
Practice Address - Street 1:10288 77TH ST STE 300
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-1134
Practice Address - Country:US
Practice Address - Phone:262-697-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001043-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice