Provider Demographics
NPI:1881725141
Name:RONALD J. WARYJAS, DDS, LTD.AR
Entity type:Organization
Organization Name:RONALD J. WARYJAS, DDS, LTD.AR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WARYJAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:708-596-2226
Mailing Address - Street 1:401 E 162ND ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2236
Mailing Address - Country:US
Mailing Address - Phone:708-596-2226
Mailing Address - Fax:708-596-2227
Practice Address - Street 1:401 E 162ND ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2236
Practice Address - Country:US
Practice Address - Phone:708-596-2226
Practice Address - Fax:708-596-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty