Provider Demographics
NPI:1568636702
Name:JJ BIANCLANA ENTERPRISES, INC.
Entity Type:Organization
Organization Name:JJ BIANCLANA ENTERPRISES, INC.
Other - Org Name:BURLINGTON DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BIANCALANA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-683-9812
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60109-0400
Mailing Address - Country:US
Mailing Address - Phone:847-683-9812
Mailing Address - Fax:847-683-9801
Practice Address - Street 1:255 S. MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IL
Practice Address - Zip Code:60109
Practice Address - Country:US
Practice Address - Phone:847-683-9812
Practice Address - Fax:847-683-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental