Provider Demographics
NPI:1801698030
Name:PAUL, PAIGE MADDEN (DMD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:MADDEN
Last Name:PAUL
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:MCKENZIE
Other - Last Name:MADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:10S515 HAVENS DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-5126
Mailing Address - Country:US
Mailing Address - Phone:239-850-6229
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program