Provider Demographics
NPI:1255610812
Name:ORIANNA ALBAZI, DDS P.C.
Entity type:Organization
Organization Name:ORIANNA ALBAZI, DDS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ORIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBAZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-423-8353
Mailing Address - Street 1:8430 W ROSEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1854
Mailing Address - Country:US
Mailing Address - Phone:615-423-8353
Mailing Address - Fax:
Practice Address - Street 1:8430 W ROSEVIEW DR
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1854
Practice Address - Country:US
Practice Address - Phone:615-423-8353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028240122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty