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Lydia Jael Dejonge, DDS
Pediatric Dentist in Oak Lawn, Illinois
NPI 1164042198

Lydia Jael Dejonge is a Pediatric Dentist based in Oak Lawn, IL and is specialized in Pediatric Dentistry. Lydia Jael Dejonge practices in Oak Lawn, IL and has the professional credentials of DDS. The NPI Number for Lydia Jael Dejonge is 1164042198 and holds a License No. (Illinois).

The current practice location address for Lydia Jael Dejonge is 6305 W 95Th St Ste 200, Oak Lawn, IL and can be reached out via phone at 708-424-1300.

Location: 6305 W 95Th St Ste 200, Oak Lawn, IL, 60453-2795
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164042198
Provider Name
Lydia Jael Dejonge
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
6305 W 95Th St Ste 200, Oak Lawn, IL, 60453-2795
Phone Number
708-424-1300
Fax Number
Provider Enumeration Date
04/20/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
6305 W 95Th St Ste 200
City
Oak Lawn
State
Illinois
Zip
60453-2795
Phone Number
708-424-1300
Fax Number
person
Provider Business Mailing Address Details
Address
6305 W 95Th St Ste 200
City
Oak Lawn
State
Illinois
Zip
60453-2795
Phone Number
708-424-1300
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
021.003285 (Illinois)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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