Provider Demographics
NPI:1508219403
Name:WENDLAND, MEGHAN ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:WENDLAND
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 1:200 N ARLINGTON HEIGHTS RD APT 709
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-6051
Mailing Address - Country:US
Mailing Address - Phone:218-349-9176
Mailing Address - Fax:
Practice Address - Street 1:1029 E 130TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-6908
Practice Address - Country:US
Practice Address - Phone:773-995-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.030973122300000X
CA100008122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist