DR. JOSEPH J MARDJETKO (NPI# 1033312350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033312350 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH J MARDJETKO |
| Credential | DDS |
| Practice Address |
12721 S Harlem Ave Palos Heights IL 60463 |
| Practice Telephone | 7084489415 |
| Practice Fax Number | 7084489423 |
| Mailing Telephone | 7084489415 |
| Mailing Fax Number | 7084489423 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D19022149 | IL | Dental Providers |
| Street Address |
12721 S HARLEM AVE |
| City | PALOS HEIGHTS |
| State | IL |
| Zip Code | 60463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417159096 | Richard J Mckane | Dentist | 12721 S Harlem Ave, Palos Heights, IL 60463 | 2007-06-05 |
| 1730494147 | Amanda Romsa | Dentist | 12721 S Harlem Ave, Palos Heights, IL 60463-2178 | 2010-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932756095 | Kim Rusiecki | Technician | 25 Parliament Drive East, Palos Heights, IL 60463 | 2019-08-23 |
| 1265925218 | Sentinel Anesthesia of Illinois, PC | Anesthesiology | 7340 W College Dr Fl 1, Palos Heights, IL 60463 | 2018-06-13 |
| 1225410848 | Deborah Ann Castaneda | Skilled Nursing Facility | 12350 Natchez Ave., Palos Heights, IL 60463 | 2015-06-19 |
| 1609253160 | Tareq Ayyad | Physical Therapy Assistant | 11730 Lighthouse Ln, Palos Heights, IL 60463 | 2015-05-04 |
| 1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
| 1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
| 1275976045 | Nazim A. Khan | Physician Assistant | 6450 West College Drive, Palos Heights, IL 60463 | 2013-04-11 |
| 1619246824 | Amanda M Ejka | Psychologist | 11800 South 75th Avenue, Suite 300, Palos Heights, IL 60463 | 2011-12-16 |
| 1578832937 | Sandi Maheras | Pharmacist | 1703 Spyglass Cir, Palos Heights, IL 60463 | 2011-12-14 |
| 1043597065 | Ashraf Olwan | Pharmacist | 7660 W Sequoia Rd, Palos Heights, IL 60463 | 2011-11-04 |
| Find all providers in zip 60463 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447769435 | Tanvi Mehta | Dentist | 13303 S Ridgeland Ave Unit A, Palos Heights, IL 60463-0020 | 2017-09-22 |
| 1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
| 1407042047 | John Francis Hart Jr. | Dentist | 7350 College Dr, Ste 203, Palos Heights, IL 60463-1190 | 2007-09-18 |
| 1417159096 | Richard J Mckane | Dentist | 12721 S Harlem Ave, Palos Heights, IL 60463 | 2007-06-05 |
| 1518169192 | Leslie A Mckane | Dentist | 12721 S Harlem Avenue, Palos Heights, IL 60463 | 2007-06-05 |
| 1831318997 | Victoria Marie Vorderer | Dentist | 7600 W College Drive, Palos Heights, IL 60463 | 2007-04-25 |
| 1831253921 | Walid Habbal Dds PC | Dentist | 12612 S Harlem Ave, Palos Heights, IL 60463 | 2006-12-21 |
| 1588725477 | Michael Patrick Meehan | Dentist | 6745 W 127th St, Palos Heights, IL 60463 | 2006-12-13 |
| 1114093838 | Pavletic Pavletic and Vorderer Dds Ltd | Dentist | 7600 College Dr, Palos Heights, IL 60463 | 2006-11-27 |
| 1073688321 | Lawrence J Meekma Dds Ltd | Dentist | 7400 College Drive, Palos Heights, IL 60463 | 2006-11-22 |
| Find all providers in PALOS HEIGHTS | ||||
| City | PALOS HEIGHTS |
| Zip Code | 60463 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.