Provider Demographics
NPI:1659101905
Name:VANOPDORP, CLAUDIA (DDS)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:VANOPDORP
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 1:438 S MASON ST
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:61361-9798
Mailing Address - Country:US
Mailing Address - Phone:309-945-5284
Mailing Address - Fax:
Practice Address - Street 1:217 MARKET ST
Practice Address - Street 2:
Practice Address - City:GALVA
Practice Address - State:IL
Practice Address - Zip Code:61434-1766
Practice Address - Country:US
Practice Address - Phone:309-932-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0353731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty