Individual
JEYANTHI BHAHEETHARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3450 LACEY RD, DOWNERS GROVE, IL 60515-5430
(630) 743-4500
Mailing address
3450 LACEY RD, DENTAL INSTITUTE, DOWNERS GROVE, IL 60515-5430
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019033409
IL
Other
Enumeration date
07/06/2018
Last updated
01/12/2026
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