Provider Demographics
NPI:1124032867
Name:DINA LUNKEN DDS, PC
Entity type:Organization
Organization Name:DINA LUNKEN DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DINA
Authorized Official - Middle Name:F
Authorized Official - Last Name:LUNKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-223-6622
Mailing Address - Street 1:803 21ST ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-1584
Mailing Address - Country:US
Mailing Address - Phone:815-223-6622
Mailing Address - Fax:
Practice Address - Street 1:803 21ST ST
Practice Address - Street 2:SUITE B
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-1584
Practice Address - Country:US
Practice Address - Phone:815-223-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty