Provider Demographics
NPI:1023023892
Name:SMYK, LADA Z (DDS)
Entity Type:Individual
Prefix:DR
First Name:LADA
Middle Name:Z
Last Name:SMYK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S MILWAUKEE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5072
Mailing Address - Country:US
Mailing Address - Phone:847-215-6600
Mailing Address - Fax:847-276-3633
Practice Address - Street 1:401 S MILWAUKEE AVE STE 200
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5072
Practice Address - Country:US
Practice Address - Phone:847-215-6600
Practice Address - Fax:847-276-3633
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0262911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice