Provider Demographics
NPI:1295244911
Name:MAYA, AMY SARA (DDS)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:SARA
Last Name:MAYA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3926
Mailing Address - Country:US
Mailing Address - Phone:908-295-3666
Mailing Address - Fax:
Practice Address - Street 1:640 S MONROE ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3926
Practice Address - Country:US
Practice Address - Phone:082-953-6669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02688000122300000X
IL019.0320811223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No122300000XDental ProvidersDentist