Provider Demographics
NPI:1285389981
Name:BASHIRI, RAHIMA (DDS)
Entity type:Individual
Prefix:
First Name:RAHIMA
Middle Name:
Last Name:BASHIRI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 STATION BLVD APT 219
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4047
Mailing Address - Country:US
Mailing Address - Phone:346-414-1919
Mailing Address - Fax:
Practice Address - Street 1:956 N NELTNOR BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-5982
Practice Address - Country:US
Practice Address - Phone:630-293-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0334171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice