Provider Demographics
NPI:1194766410
Name:DANA, STEVEN J (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:DANA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18906 SPRING CREEK ST
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9672
Mailing Address - Country:US
Mailing Address - Phone:708-354-3135
Mailing Address - Fax:
Practice Address - Street 1:18906 SPRING CREEK ST
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9672
Practice Address - Country:US
Practice Address - Phone:708-354-3135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0163471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice