Taras Martyniouk, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019.030683 Issued in IL

Practice address

310 S Greenleaf St Ste 203
Gurnee, IL 60031-5708

Phone

(847) 623-5915

NPI assigned

Sep 1, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premiere Anesthesia Group LLC

  • Certified Registered Nurse Anesthetist
  • Park Ridge, IL
  • NPI 1720467392
  NPD (past)
• Walter Tatch, D.D.S., LTD.

  • Oral and Maxillofacial Surgery (Dentist)
  • Gurnee, IL
  • NPI 1356423891
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1730636267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S GREENLEAF ST STE 203",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315708",
            "telephone_number": "847-623-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S GREENLEAF ST STE 203",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315708",
            "telephone_number": "847-623-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTYNIOUK",
        "first_name": "TARAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030683",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "108875",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.030683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Marigliano, LPC
• Maria Catalina Marion
• Violetta Markaryan, NP
• Ana Alicia Maroon, LCPC
• Daniel Martinez
• Brenda Marwede, LCPC
• Jennifer Mateo
• Shaina Mathews, OD
• Mary Caitlin Mathewson, BCBA
• John W Matseshe, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.