Provider Demographics
NPI:1962119859
Name:ALNAASAN, FAISAL (DDS)
Entity type:Individual
Prefix:
First Name:FAISAL
Middle Name:
Last Name:ALNAASAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 S INDIANA AVE APT 2009
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2782
Mailing Address - Country:US
Mailing Address - Phone:347-755-8607
Mailing Address - Fax:
Practice Address - Street 1:3425 S KING DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4108
Practice Address - Country:US
Practice Address - Phone:312-313-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0339931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice