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General NPI Number Information
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NPI Number | 1235709213
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Entity Type | Individual
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Provider Name | CARMEN I URIBE CARDENAS DMD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 302 E SAINT CHARLES RD STE A
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City | VILLA PARK
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State | IL
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Zip | 60181-2473
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Country | US
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Telephone | 630-339-3438
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Fax | 630-686-8414
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Provider Business Mailing Address
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Address Line | 302 E SAINT CHARLES RD STE A
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City | VILLA PARK
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State | IL
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Zip | 60181-2473
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Country | US
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Telephone | 630-339-3438
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Fax | 630-686-8414
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.033290
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License Number State | IL
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