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General NPI Number Information
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NPI Number | 1063032464
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Entity Type | Individual
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Provider Name | SILSAN KAMINSKI RDH
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Gender | Female
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Dates
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Enumeration Date | 04/26/2020
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Last Update Date | 05/24/2020
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Provider Practice Location Address
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Address Line | 430 DIXIE HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-1799
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Country | US
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Telephone | 708-808-4950
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Fax |
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Provider Business Mailing Address
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Address Line | 2707 WESTWIND DR
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City | VALPARAISO
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State | IN
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Zip | 46385-7215
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Country | US
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Telephone | 219-801-5826
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 13007000A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 020.013888
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License Number State | IL
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