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General NPI Number Information
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NPI Number | 1538566328
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Entity Type | Individual
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Provider Name | ALAYNA CONSTANCE CORDEN D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/23/2014
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 10258 SOUTHWEST HWY STE C
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City | CHICAGO RIDGE
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State | IL
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Zip | 60415-1361
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Country | US
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Telephone | 708-576-8442
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Fax |
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Provider Business Mailing Address
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Address Line | 10258 SOUTHWEST HWY STE C
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City | CHICAGO RIDGE
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State | IL
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Zip | 60415-1361
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Country | US
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Telephone | 248-910-2194
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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 | 019.030838
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 021.002770019.030838
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DGD 8469
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License Number State | SC
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