Martin Peter Kornak, DDS
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Riverside, IL
NPI 1508964057 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508964057
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- Practice address
- 84 E Burlington St
Riverside, IL 60546-2118 - Phone
- (708) 447-9299
- Fax
- (708) 447-9322
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021000851 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin P Kornak DDS LTD | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | IL | Yes |
Addresses
Primary practice location
84 E Burlington St
Riverside, IL 60546-2118
Mailing address
84 E Burlington St
Riverside, IL 60546-2118
Phone (708) 447-9299
Other providers in Riverside, IL
- Jennifer Kang
- Deepika Karki
- Nithya Karpagavinayagam
- Nicole Kasperek
- Amy Lee Kienow Paychek
- Deborah J. Krause
- Diana Alexandra Kreppel
- Catherine J Kruse
- Todd Michael Kubon
- Gilbert Joseph Lafemina
All providers in Riverside, IL · Orthodontics and Dentofacial Orthopedics Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.