Provider Demographics
NPI:1700911146
Name:THE DENTAL SPECIALISTS
Entity Type:Organization
Organization Name:THE DENTAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:630-960-4447
Mailing Address - Street 1:6319 FAIRVIEW AVE
Mailing Address - Street 2:103
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2888
Mailing Address - Country:US
Mailing Address - Phone:630-960-4447
Mailing Address - Fax:630-960-3135
Practice Address - Street 1:6319 FAIRVIEW AVE
Practice Address - Street 2:103
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2888
Practice Address - Country:US
Practice Address - Phone:630-960-4447
Practice Address - Fax:630-960-3135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty