Healthcare Provider Details

I. General information

NPI: 1750178745
Provider Name (Legal Business Name): KAROLINA MARIKA DANIELISZYN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1637 MAIN ST
ONALASKA WI
54650-2853
US

IV. Provider business mailing address

878 LONGBOAT LN
SCHAUMBURG IL
60194-1317
US

V. Phone/Fax

Practice location:
  • Phone: 608-781-3999
  • Fax:
Mailing address:
  • Phone: 630-506-3168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6001838-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: