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General NPI Number Information
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NPI Number | 1467356089
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Entity Type | Individual
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Provider Name | MS. ARDITA AJDINI
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Gender | Female
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 2809 MANSION RD STE D
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City | SPRINGFIELD
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State | IL
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Zip | 62711-6811
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Country | US
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Telephone | 217-269-1534
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 GRANTS POND
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City | CHATHAM
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State | IL
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Zip | 62629-4409
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Country | US
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Telephone | 217-652-6335
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019037495
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License Number State | IL
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