Provider Demographics
NPI:1508008988
Name:GLOBAL DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:GLOBAL DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:TISMENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-316-1993
Mailing Address - Street 1:8269 W GOLF RD
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1156
Mailing Address - Country:US
Mailing Address - Phone:312-316-1993
Mailing Address - Fax:
Practice Address - Street 1:8269 W GOLF RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1156
Practice Address - Country:US
Practice Address - Phone:312-316-1993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190259781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty