Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JONATHAN KENNETH RAKSTANG, DDS
Active Sole ProprietorDR. JONATHAN KENNETH RAKSTANG, DDS is a Orthodontics healthcare provider located in BURBANK, Illinois. NPI 1366772287 is currently active in the NPPES registry. Verify at CMS.
Orthodontics · BURBANK, IL
Registration Details
- NPI Number
- 1366772287
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 29, 2009 (16.617294296585 yrs)
- Last Updated
- Sep 8, 2021
- Licenses
-
8923 (CO)3740 (AR)019.032870 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7820 S CICERO AVEBURBANK, IL, 604591584Browse IL providers · Browse ZIP 60459
- Phone
- 7083915220
- Primary Specialty
-
Orthodontics
1223X0400X
- Additional Specialty
- Dentist
- Additional Specialty
- Orthodontics
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.