Mazen Eisho

Primary specialty

DentistTaxonomy code 122300000X

License

019033326 Issued in IL

Practice address

722 Rand Grove LN Apt 2a
Palatine, IL 60074-1148

Phone

(773) 952-9109

NPI assigned

Jul 23, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dentistry and Beyond Inc

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1568393726
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1033782271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 RAND GROVE LN APT 2A",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600741148",
            "telephone_number": "773-952-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 RAND GROVE LN APT 2A",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600741148",
            "telephone_number": "773-952-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISHO",
        "first_name": "MAZEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019033326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine M Duong, M.D.
• La Tanya Durant, LMT
• Regina Dziewior, MA
• Eickhorst Family Chiropractic Inc
• Eric Eickhorst, DC
• Elite Dentistry
• Elite Health&Wellness Centers Inc.
• Anne L Ellis, MA CCC
• Shahad Elttayef, DMD
• Enjoy Mobile Rehab (Enjoy Therapeutics)

• Dentist in Palatine, IL
• Providers in Palatine, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.