Provider Demographics
NPI:1306574660
Name:CASACLANG, ARIELLE (DMD)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:CASACLANG
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 1:2328 S GOEBBERT RD APT 1092
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-5100
Mailing Address - Country:US
Mailing Address - Phone:847-980-3281
Mailing Address - Fax:
Practice Address - Street 1:495 N RIVERSIDE DR STE 204
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5920
Practice Address - Country:US
Practice Address - Phone:847-336-8611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0338201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice