Individual
DR. KAVEH NASIREDDIN ADEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
612 E OGDEN AVE, NAPERVILLE, IL 60563-3237
(630) 369-8950
(630) 369-7342
Mailing address
612 E OGDEN AVE, NAPERVILLE, IL 60563-3237
(630) 369-8950
(630) 369-7342
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019024954
IL
1223G0001X
General Practice Dentistry
019024954
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019024954
ILLINOIS DENTAL LICENSE
IL
01
—
050970328
ADA MEMBERSHIP #
IL
Enumeration date
11/14/2006
Last updated
03/07/2023
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