Provider Demographics
NPI:1851657142
Name:SONNEVELD, CRAIG BRENDAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:BRENDAN
Last Name:SONNEVELD
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 1:14200 WOODWARD DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2321
Mailing Address - Country:US
Mailing Address - Phone:708-403-0507
Mailing Address - Fax:
Practice Address - Street 1:125 COOL SPRINGS BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6474
Practice Address - Country:US
Practice Address - Phone:615-771-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics