Provider Demographics
NPI:1972572915
Name:MALINOWSKI, SHARON ANTOINETTE (DDS)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANTOINETTE
Last Name:MALINOWSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7770 LINDER AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-1353
Mailing Address - Country:US
Mailing Address - Phone:708-422-5200
Mailing Address - Fax:708-422-6984
Practice Address - Street 1:11000 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-5719
Practice Address - Country:US
Practice Address - Phone:708-422-5200
Practice Address - Fax:708-422-6984
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice