Ashton Dental PC
Organization Active NPI General Practice Dentistry · Homer Glen, IL
NPI 1588055941 · NPPES record last updated Dec 10, 2020
Key facts
- NPI
- 1588055941
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019024809 (IL)
- Legal business name
- ASHTON DENTAL PC
- Practice address
- 14403 S Bell Rd
Homer Glen, IL 60491-7881 - Phone
- (331) 431-9059
- NPI assigned
- Feb 6, 2015
- Organization subpart
- No
Authorized official
- Name
- Sohail S Shafi
- Title
- Manager
- Phone
- (630) 842-3705
Corporate family (same tax ID) 10
Practitioners 3
-
Candace Susan Ruff, BS, DMD
-
Inas Mohammed Rahima, DMD
National Provider Directory
- Tax ID family
- Smile Town Dental
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 019024809 | IL | Yes |
Addresses
Primary practice location
14403 S Bell Rd
Homer Glen, IL 60491-7881
Mailing address
1730 Park St Ste 106
Naperville, IL 60563-2609
Phone (708) 966-4018
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019024809 | Medicaid | IL |
Other names
- Eco Dental
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All providers in Homer Glen, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2020. 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.