Provider Demographics
NPI:1114002359
Name:LANGYEL, EILEEN MARY (DDS SC)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:MARY
Last Name:LANGYEL
Suffix:
Gender:F
Credentials:DDS SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3783 SO 108TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228
Mailing Address - Country:US
Mailing Address - Phone:414-546-3424
Mailing Address - Fax:414-546-3424
Practice Address - Street 1:3783 SO 108TH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228
Practice Address - Country:US
Practice Address - Phone:414-546-3424
Practice Address - Fax:414-546-3424
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3508122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3793520003OtherUNEMPLOYMENT INS
WI33480400Medicaid