Provider Demographics
NPI:1447758313
Name:HEALTH FIRST DENTAL
Entity type:Organization
Organization Name:HEALTH FIRST DENTAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-466-7392
Mailing Address - Street 1:1037 E WOODFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4706
Mailing Address - Country:US
Mailing Address - Phone:847-466-7392
Mailing Address - Fax:
Practice Address - Street 1:1037 E WOODFIELD RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4706
Practice Address - Country:US
Practice Address - Phone:847-466-7392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASIM M. ANSARI DDS. PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.028486261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental