Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Omar Moukaddem, DMD

Individual provider Dentist · NPI 1336718659

Dr. Omar Moukaddem, DMD is a Dentist in Addison, Illinois. Licensed in Illinois. Registered with an NPI since 2021.

Licensed in
IL
In the registry since
2021
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

200 W Lake St
Addison, IL 60101-2513
Phone: (630) 628-3115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019.033148 (IL)

Record details

NPI number1336718659
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJune 21, 2021
Last updated in NPPESJune 21, 2021
Certification dateJune 21, 2021
Mailing address200 W Lake St, Addison, IL 60101-2513

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