Provider Demographics
NPI:1811206519
Name:DEMIAN, ADINA SIMONA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADINA
Middle Name:SIMONA
Last Name:DEMIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 N NRTHWST HWY STE 6
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1852
Mailing Address - Country:US
Mailing Address - Phone:773-647-1022
Mailing Address - Fax:
Practice Address - Street 1:6400 N NRTHWST HWY STE 6
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1852
Practice Address - Country:US
Practice Address - Phone:773-647-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028330122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist