Provider Demographics
NPI:1992549620
Name:APPLE FAMILY DENTAL, P.C.
Entity type:Organization
Organization Name:APPLE FAMILY DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLUBYANTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-415-0465
Mailing Address - Street 1:712 LEE ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4584
Mailing Address - Country:US
Mailing Address - Phone:847-296-8111
Mailing Address - Fax:
Practice Address - Street 1:712 LEE ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4584
Practice Address - Country:US
Practice Address - Phone:847-296-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty