Provider Demographics
NPI:1245451996
Name:JAVIER, MARIA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:JAVIER
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N CANAL ST
Mailing Address - Street 2:APT 3103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1208
Mailing Address - Country:US
Mailing Address - Phone:630-670-6143
Mailing Address - Fax:
Practice Address - Street 1:3247 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2129
Practice Address - Country:US
Practice Address - Phone:773-281-8320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0210023001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry