Provider Demographics
NPI:1447382031
Name:ARISTODEMO, GIOVANNI (DDS)
Entity Type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:
Last Name:ARISTODEMO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 W DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-3904
Mailing Address - Country:US
Mailing Address - Phone:847-808-8300
Mailing Address - Fax:847-808-8301
Practice Address - Street 1:1205 W DUNDEE RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-3904
Practice Address - Country:US
Practice Address - Phone:847-808-8300
Practice Address - Fax:847-808-8301
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist