Provider Demographics
NPI:1467526624
Name:LASKARIS, NIKI RIMBAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIKI
Middle Name:RIMBAS
Last Name:LASKARIS
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 1:832 BUSSE HWY
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2302
Mailing Address - Country:US
Mailing Address - Phone:847-823-6400
Mailing Address - Fax:847-823-1168
Practice Address - Street 1:832 BUSSE HWY
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-2302
Practice Address - Country:US
Practice Address - Phone:847-823-6400
Practice Address - Fax:847-823-1168
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0212651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL364301743OtherFEDERAL TAX ID