Provider Demographics
NPI:1023280229
Name:ADATIA, MAYANK R (DDS)
Entity type:Individual
Prefix:DR
First Name:MAYANK
Middle Name:R
Last Name:ADATIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1013 SHEPPEY CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-6109
Mailing Address - Country:US
Mailing Address - Phone:847-769-4132
Mailing Address - Fax:847-310-6796
Practice Address - Street 1:853 N HIGHLAND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2217
Practice Address - Country:US
Practice Address - Phone:630-844-3368
Practice Address - Fax:630-844-2873
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist