Provider Demographics
NPI:1609921394
Name:MARTIN J PIEKOS D.D.S. & LORETTE M LUKSHA D.D.S.,P.C.
Entity Type:Organization
Organization Name:MARTIN J PIEKOS D.D.S. & LORETTE M LUKSHA D.D.S.,P.C.
Other - Org Name:DRS. PIEKOS & LUKSA, DDS,PC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIEKOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-823-6100
Mailing Address - Street 1:8222 W OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2723
Mailing Address - Country:US
Mailing Address - Phone:847-823-6100
Mailing Address - Fax:847-823-8450
Practice Address - Street 1:8222 W OAKTON ST
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2723
Practice Address - Country:US
Practice Address - Phone:847-823-6100
Practice Address - Fax:847-823-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty