# KHAVIS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dream Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861102329
- **Authorized official:** RAFAEL KHAVIS DDS (STATUTORY AGENT/DENTIST)
- **Authorized official phone:** (917) 822-4185

## Contact information

- **Practice address:** 5596 MAYFIELD RD, LYNDHURST, OH 44124-2921
- **Practice address phone:** (440) 442-8220
- **Mailing address:** 4499 GROVELAND RD, UNIVERSITY HEIGHTS, OH 44118-3920

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/24/2022
- **Last updated:** 11/24/2022