1205844354 NPI number — DR. ABRAHAM ISAAC DUMANIS D.S.,D.D.S.

Table of content: DR. ABRAHAM ISAAC DUMANIS D.S.,D.D.S. (NPI 1205844354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205844354 NPI number — DR. ABRAHAM ISAAC DUMANIS D.S.,D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUMANIS
Provider First Name:
ABRAHAM
Provider Middle Name:
ISAAC
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.S.,D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205844354
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
805 WINCHESTER LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHBROOK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60062-3300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-341-4204
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9933 LAWLER AVE STE 501
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SKOKIE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60077-4302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-329-9858
Provider Business Practice Location Address Fax Number:
847-329-9768
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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