Provider Demographics
NPI:1013696673
Name:JANCEVICIUTE, ARMINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARMINA
Middle Name:
Last Name:JANCEVICIUTE
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 1:9055 S ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-3812
Mailing Address - Country:US
Mailing Address - Phone:708-598-4055
Mailing Address - Fax:
Practice Address - Street 1:9055 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-3812
Practice Address - Country:US
Practice Address - Phone:709-598-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190343221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice