Omar Moukaddem, DMD

Dentist · Addison, IL

Individual Active NPI

NPI number 1336718659

Practice location

200 W Lake St
Addison, IL 60101-2513
Phone
(630) 628-3115

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NPI record

NPI
1336718659
Entity type
Individual (Type 1)
Enumeration date
June 21, 2021
Last updated
June 21, 2021
Certified
June 21, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019.033148 IL

About Dr. Moukaddem

Omar Moukaddem, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 200 W Lake St, Addison, IL 60101-2513. The NPI number 1336718659 was assigned on June 21, 2021 and the record was last updated on June 21, 2021.

Dr. Moukaddem lists a license in the registry: #019.033148 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Omar Moukaddem, DMD?

The NPI number is 1336718659.

What is the phone number of Dr. Moukaddem?

The phone number listed for the practice location is (630) 628-3115.

Where is Dr. Moukaddem located?

200 W Lake St, Addison, IL 60101-2513.

What is the taxonomy code for Dr. Moukaddem?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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