Tooba Bint-E- Ajmal, DDS
Individual provider Active NPI Dentist · Homer Glen, IL
NPI 1588030795 · NPPES record last updated Jan 18, 2023
Key facts
- NPI
- 1588030795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019030425 (IL)
- Practice address
- 15750 S Bell Rd
Homer Glen, IL 60491-8412 - Phone
- (708) 301-2211
- NPI assigned
- Aug 12, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019030425 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Experts, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019030425 | IL | Yes |
Addresses
Primary practice location
15750 S Bell Rd
Homer Glen, IL 60491-8412
Mailing address
15750 S Bell Rd Ste 1B
Homer Glen, IL 60491-8420
Phone (630) 677-1386
Other providers in Homer Glen, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.