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General NPI Number Information
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NPI Number | 1801313358
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Entity Type | Organization
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Legal Business Name | ALAYNA CORDEN DMD, MS, PC
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Dates
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Enumeration Date | 08/25/2017
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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 | 2323 N LEAVITT ST APT 201
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City | CHICAGO
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State | IL
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Zip | 60647-6805
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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 | OWNER
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Name | ALAYNA CORDEN
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Credential | DMD, MS
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Telephone | 248-910-2194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 019030838
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 319020139
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 021002770
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License Number State | IL
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