Provider Demographics
NPI:1568410116
Name:TAPIADOR, RICARDO G (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:G
Last Name:TAPIADOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-3671
Mailing Address - Country:US
Mailing Address - Phone:847-662-2121
Mailing Address - Fax:847-625-9688
Practice Address - Street 1:1531 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-3671
Practice Address - Country:US
Practice Address - Phone:847-662-2121
Practice Address - Fax:847-625-9688
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19-A156761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice