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General NPI Number Information
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NPI Number | 1104972694
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Entity Type | Organization
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Legal Business Name | OAKBROOK ENDODONTIC ASSOCIATES, LTD.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 OAKBROOK CTR #714
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City | OAK BROOK
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State | IL
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Zip | 60523-1806
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Country | US
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Telephone | 630-654-3331
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Fax | 630-954-2910
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Provider Business Mailing Address
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Address Line | 120 OAKBROOK CTR #714
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City | OAK BROOK
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State | IL
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Zip | 60523-1806
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Country | US
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Telephone | 630-654-3331
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Fax | 630-954-2910
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES F GIANAKAKIS
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Credential | D.D.S.,M.S.
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Telephone | 630-654-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State | IL
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