Provider Demographics
NPI:1861781080
Name:LUEDI, SPOMENKA M (DDS)
Entity type:Individual
Prefix:DR
First Name:SPOMENKA
Middle Name:M
Last Name:LUEDI
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 1:728 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2901
Mailing Address - Country:US
Mailing Address - Phone:630-969-3900
Mailing Address - Fax:630-969-3923
Practice Address - Street 1:728 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2901
Practice Address - Country:US
Practice Address - Phone:630-969-3900
Practice Address - Fax:630-969-3923
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0152401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice