1578733564 NPI number — DR. MAHENDRA DAHYALAL TOLIA D.D.S.

Table of content: DR. MAHENDRA DAHYALAL TOLIA D.D.S. (NPI 1578733564)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578733564 NPI number — DR. MAHENDRA DAHYALAL TOLIA D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOLIA
Provider First Name:
MAHENDRA
Provider Middle Name:
DAHYALAL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
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:
TOLIA
Provider Other First Name:
MAHENDRA
Provider Other Middle Name:
DAHYALAL
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.D.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1578733564
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
417 DUNDEE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELGIN
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60120-3830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-608-7910
Provider Business Mailing Address Fax Number:
847-608-7910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
417 DUNDEE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELGIN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60120-3830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-608-7910
Provider Business Practice Location Address Fax Number:
847-608-7910
Provider Enumeration Date:
03/05/2008

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)





Copyright © 2007-2025 www.npivalidator.com