Provider Demographics
NPI:1437635711
Name:MARTYNIOUK, ADITI (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADITI
Middle Name:
Last Name:MARTYNIOUK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ADITI
Other - Middle Name:
Other - Last Name:MARTYNIOUK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:2035 ENGLE RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5386
Mailing Address - Country:US
Mailing Address - Phone:224-388-0404
Mailing Address - Fax:
Practice Address - Street 1:1730 PARK ST STE 106
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2609
Practice Address - Country:US
Practice Address - Phone:630-674-7860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102808122300000X
IL019.0318681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist