Provider Demographics
NPI:1750178745
Name:DANIELISZYN, KAROLINA MARIKA (DMD)
Entity type:Individual
Prefix:
First Name:KAROLINA
Middle Name:MARIKA
Last Name:DANIELISZYN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 LONGBOAT LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-1317
Mailing Address - Country:US
Mailing Address - Phone:630-506-3168
Mailing Address - Fax:
Practice Address - Street 1:1637 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-2853
Practice Address - Country:US
Practice Address - Phone:608-781-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI6001838-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program