Healthcare Provider Details

I. General information

NPI: 1942872171
Provider Name (Legal Business Name): CHRISTIAN G TRIAND DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W FRONT AVE
STOCKTON IL
61085-1318
US

IV. Provider business mailing address

2971 TWO PATHS DR
WOODRIDGE IL
60517-4512
US

V. Phone/Fax

Practice location:
  • Phone: 815-947-3700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.033315
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: