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General NPI Number Information
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NPI Number | 1881763787
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Entity Type | Individual
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Provider Name | JOSEPH JOHN SODINI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 4923 OAKTON ST
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City | SKOKIE
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State | IL
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Zip | 60077-2903
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Country | US
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Telephone | 847-676-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 W CRESCENT AVE
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City | PARK RIDGE
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State | IL
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Zip | 60068-3830
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Country | US
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Telephone | 847-318-7681
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019019627
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License Number State | IL
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