Provider Demographics
NPI:1811677826
Name:TAKRITI, MUHAMMAD (DDS, MS)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:TAKRITI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:MOHAMD
Other - Middle Name:AHMAD
Other - Last Name:ALTAKRITI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:2132 CITY GATE LN APT 304
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3731
Mailing Address - Country:US
Mailing Address - Phone:346-303-4992
Mailing Address - Fax:
Practice Address - Street 1:2124 OGDEN AVE STE 104
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7542
Practice Address - Country:US
Practice Address - Phone:630-585-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.034380122300000X
IL021.0032661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics