Individual provider · Type 1 NPI
Jonathan Kenneth Rakstang, DDS
Orthodontics and Dentofacial Orthopedics Dentistry · Burbank, IL
Practice location
7820 S Cicero Ave
Burbank, IL 60459-1584
Mailing address
547 S Clark St Apt 1004
Chicago, IL 60605-1548
Other practice locations
- 4400 Rogers Ave, Suite C, Fort Smith, AR 72903-3145 · (303) 669-8175
- 7820 S Cicero Ave, Burbank, IL 60459-1584 · (708) 391-5220
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | 8923 (CO) |
| Dentist | 122300000X | 3740 (AR) |
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | 019.032870 (IL) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
About NPI 1366772287
Jonathan Kenneth Rakstang, DDS's National Provider Identifier is 1366772287, issued on Dec 29, 2009. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Burbank, IL. The record was last updated on Sep 8, 2021.