Dr. Sodabeh Etminan
Dentist - General Practice
7131 S Jeffery Blvd Ste A
Chicago
, Illinois 60649-2176
Dr. Sodabeh Etminan
Dentist - General Practice
7131 S Jeffery Blvd Ste A
Chicago
, Illinois 60649-2176
(312) 413-1789
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About
Features
Specialties
- General Practice
Languages spoken
- English
Location
First Address
- Dr. Sodabeh Etminan
- 1220 S Wood St
- Chicago, IL
- Zip : 60608-1202
- Phone : (312) 413-1789
Second Address
- Dr. Sodabeh Etminan
- 7131 S Jeffery Blvd Ste A
- Chicago, IL
- Zip : 60649-2176
- Phone : (773) 256-0526
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223G0001X | General Practice | 019.027979 | IL |
| Y | 213EG0000X | General Practice | 019.027979 | IL |
National Provider Identifier
| NPI | 1003047929 |
|---|---|
| Provider Name | Dr. Sodabeh Etminan |
| First Address | Chicago, IL 60608-1202 |
| Second Address | Chicago, IL 60649-2176 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2009 |
| Last Update Date | 28/09/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.