Provider Demographics
NPI:1962465401
Name:DR MARIA OSAN TOPALA AND ASSOC
Entity Type:Organization
Organization Name:DR MARIA OSAN TOPALA AND ASSOC
Other - Org Name:APPLE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KASPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-895-0724
Mailing Address - Street 1:2457 RIDGE RD
Mailing Address - Street 2:PO BOX 5214
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-5214
Mailing Address - Country:US
Mailing Address - Phone:708-895-0724
Mailing Address - Fax:708-895-0757
Practice Address - Street 1:2457 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-5214
Practice Address - Country:US
Practice Address - Phone:708-895-0724
Practice Address - Fax:708-895-0757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.027062122300000X
IL019.026968122300000X
IL019-0262441223E0200X
IL019-0257811223G0001X
IL019-0155071223G0001X
IL019-0255391223P0300X
IL019-0208511223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty