Provider Demographics
NPI:1528740875
Name:ABDELSALAM, NASER (DMD)
Entity type:Individual
Prefix:
First Name:NASER
Middle Name:
Last Name:ABDELSALAM
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 1:2457 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2711
Mailing Address - Country:US
Mailing Address - Phone:708-680-6061
Mailing Address - Fax:
Practice Address - Street 1:7508 CLARIDGE DR UNIT D
Practice Address - Street 2:
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455-2038
Practice Address - Country:US
Practice Address - Phone:773-908-9074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0343161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice