Provider Demographics
NPI:1730182486
Name:KAY, DOUGLAS L (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:L
Last Name:KAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 W 535 BUTTERFIELD ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-5628
Mailing Address - Country:US
Mailing Address - Phone:630-834-7446
Mailing Address - Fax:630-834-7490
Practice Address - Street 1:17 W 535 BUTTERFIELD ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-5628
Practice Address - Country:US
Practice Address - Phone:630-834-7446
Practice Address - Fax:630-834-7490
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190178461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice