Provider Demographics
NPI:1881324192
Name:YAKONSKYY, ANNA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:YAKONSKYY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:CIUPINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:6611 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6611 NORTH AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1043
Practice Address - Country:US
Practice Address - Phone:773-270-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0337431223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice