Whalio Doctors

NPI 1003047929

Sodabeh Etminan, DMD

Practitioner General Practice Dentistry Chicago, IL

Practice location

Address
7131 S Jeffery Blvd STE a, Chicago, IL 60649-2176
Phone
(773) 256-0526
Mailing address
1220 S Wood St, Chicago, IL 60608-1202

Registered specialties

General Practice Dentistry Primary
Dental Providers Taxonomy 1223G0001X Licence 019.027979 (IL)

Registry record

NPI
1003047929
Entity type
Individual
Sex (as registered)
Female
NPI issued
28 Jul 2009
Record last updated
28 Sep 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.