Provider Demographics
NPI:1578835583
Name:SPADONI, KATINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATINA
Middle Name:
Last Name:SPADONI
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 1:2 EXECUTIVE CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9507
Mailing Address - Country:US
Mailing Address - Phone:847-304-4442
Mailing Address - Fax:847-304-4439
Practice Address - Street 1:2 EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9507
Practice Address - Country:US
Practice Address - Phone:847-304-4442
Practice Address - Fax:847-304-4439
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019020656122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist