# ILLIANA ENDODONTICS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912070228
- **Authorized official:** DR. MICHAEL JOHN MINTZ DDS (PRESIDENT)
- **Authorized official phone:** (708) 755-2021

## Contact information

- **Practice address:** 934 RICHARD RD, DYER, IN 46311-1936
- **Practice address phone:** (219) 865-9790
- **Practice address fax:** (708) 755-2027
- **Mailing address:** 934 RICHARD RD, DYER, IN 46311-1936
- **Mailing address phone:** (219) 865-9790
- **Mailing address fax:** (708) 755-2027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 021001405 | IL | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 04/24/2026