Provider Demographics
NPI:1932267101
Name:MARK V. VALENTINAS DDS,PC
Entity type:Organization
Organization Name:MARK V. VALENTINAS DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:VALENTINAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-369-0111
Mailing Address - Street 1:1001 E CHICAGO AVE
Mailing Address - Street 2:#143
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5526
Mailing Address - Country:US
Mailing Address - Phone:630-369-0111
Mailing Address - Fax:630-369-0378
Practice Address - Street 1:1001 E CHICAGO AVE
Practice Address - Street 2:#143
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5526
Practice Address - Country:US
Practice Address - Phone:630-369-0111
Practice Address - Fax:630-369-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0178981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty