Provider Demographics
NPI:1124864236
Name:COVUT, HUMA (DMD)
Entity type:Individual
Prefix:
First Name:HUMA
Middle Name:
Last Name:COVUT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:HUMA
Other - Middle Name:
Other - Last Name:COVUT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:5876 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2428
Mailing Address - Country:US
Mailing Address - Phone:815-901-1044
Mailing Address - Fax:
Practice Address - Street 1:5876 E STATE ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2428
Practice Address - Country:US
Practice Address - Phone:815-901-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0352721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice