Provider Demographics
NPI:1720475981
Name:KARRAS, MARIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:KARRAS
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 1:5818 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3027
Mailing Address - Country:US
Mailing Address - Phone:847-677-6647
Mailing Address - Fax:847-677-6906
Practice Address - Street 1:5818 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-3027
Practice Address - Country:US
Practice Address - Phone:847-677-6647
Practice Address - Fax:847-677-6906
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02843300390200000X
IL019.0302711223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019030271OtherLICENSE