Provider Demographics
NPI:1952384778
Name:SEMENY, OKSANA (DDS)
Entity type:Individual
Prefix:
First Name:OKSANA
Middle Name:
Last Name:SEMENY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:OKSANA
Other - Middle Name:
Other - Last Name:GUTERZON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 E CAMP MCDONALD RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60070-1527
Mailing Address - Country:US
Mailing Address - Phone:847-818-9250
Mailing Address - Fax:847-818-9239
Practice Address - Street 1:5 E CAMP MCDONALD RD
Practice Address - Street 2:
Practice Address - City:PROSPECT HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60070-1527
Practice Address - Country:US
Practice Address - Phone:847-818-9250
Practice Address - Fax:847-818-9239
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0260151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1780122465Medicaid