Provider Demographics
NPI:1962655837
Name:ARREDONDO, JOSEPH G (DDS)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:G
Last Name:ARREDONDO
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 1:120 OAKBROOK CENTER MALL
Mailing Address - Street 2:STE #802
Mailing Address - City:OAKBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523
Mailing Address - Country:US
Mailing Address - Phone:630-571-3030
Mailing Address - Fax:630-571-1977
Practice Address - Street 1:120 OAKBROOK CENTER MALL
Practice Address - Street 2:STE 802
Practice Address - City:OAKBROOK
Practice Address - State:IL
Practice Address - Zip Code:60523
Practice Address - Country:US
Practice Address - Phone:630-571-3030
Practice Address - Fax:630-571-1977
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0239941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice