Provider Demographics
NPI:1750449039
Name:ORENDACH, FREDERICK J (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:J
Last Name:ORENDACH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 ARCHER AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2203
Mailing Address - Country:US
Mailing Address - Phone:773-586-6622
Mailing Address - Fax:773-586-6622
Practice Address - Street 1:7101 ARCHER AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2203
Practice Address - Country:US
Practice Address - Phone:773-586-6622
Practice Address - Fax:773-586-6622
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19 A13187122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist