Avicenna Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

AVICENNA DENTAL LLC

Practice address

10415 S Roberts Rd
Palos Hills, IL 60465-1931

Phone

(708) 581-5151

Fax

(708) 581-5184

NPI assigned

Jan 25, 2023

Last updated

Jan 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adham Badwan, DMDNPI 1922475862

Title

Owner

Phone

(708) 856-7175

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adham Raji Badwan, DMD

  • Dentist
  • Orland Park, IL
  • NPI 1922475862
  Authorized official Same address or phone

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1194431916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10417 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651931",
            "telephone_number": "708-856-7175",
            "fax_number": "708-581-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651931",
            "telephone_number": "708-581-5151",
            "fax_number": "708-581-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVICENNA DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "BADWAN",
        "authorized_official_first_name": "ADHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-856-7175",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Astroth Chiropractic, P.C.
• Robert Joseph Astroth, D.C.
• Haya Attieh
• Sandeep K. Atwal, APN
• Avail Chiropractic LLC
• Avicenna Health Center Corp
• Sara Awwad
• Glenn E Bailey, D.D.S.
• Vijay Bajaj, M.D.
• Gregg Randall Baker

• Dentist in Palos Hills, IL
• Providers in Palos Hills, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.