Provider Demographics
NPI:1124676507
Name:ABUFARHA, NAJEEB M (DMD)
Entity type:Individual
Prefix:DR
First Name:NAJEEB
Middle Name:M
Last Name:ABUFARHA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 GABRIELLA ST UNIT 601
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-3991
Mailing Address - Country:US
Mailing Address - Phone:773-546-8648
Mailing Address - Fax:
Practice Address - Street 1:7409 WOODRIDGE DR STE B
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2249
Practice Address - Country:US
Practice Address - Phone:773-546-8648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190322981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice