DR. MATTHEW MARK WITKOWSKI (NPI# 1508366717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508366717 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW MARK WITKOWSKI |
| Credential | DMD |
| Practice Address |
19615 Governors Hwy Flossmoor IL 60422-2037 |
| Practice Telephone | 7082218343 |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2019-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019032088 | IL | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 27005 76th Ave, New Hyde Park, NY 110401402 | 3134076569 |
| Street Address |
19615 GOVERNORS HWY |
| City | FLOSSMOOR |
| State | IL |
| Zip Code | 60422-2037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740341973 | Charles J Greenebaum | Dentist | 19615 Governors Hwy, Flossmoor, IL 60422-2037 | 2006-12-12 |
| 1639325293 | The Center for Dental Excellence, LLC | Dentist | 19615 Governors Hwy, Flossmoor, IL 60422-2037 | 2008-08-14 |
| 1063561231 | Barbara Lynn Malone | Dentist | 19615 Governors Hwy, Flossmoor, IL 60422 | 2007-01-09 |
| 1215098074 | Cary N Goldberg | Dentist | 19615 Governors Hwy, Flossmoor, IL 60422-2037 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274310 | Miranda Home Health Care Inc | Nursing Care | 19150 S. Kedzie Ave, 203, Flossmoor, IL 60422 | 2020-08-06 |
| 1285256172 | Bp Behavioral Services, LLC | Behavioral Analyst | 2222 Marston Lane, Flossmoor, IL 60422 | 2020-05-13 |
| 1891164133 | Lauren Simpson | Behavioral Analyst | 19530 Kezie Avenue, Flossmoor, IL 60422 | 2015-09-16 |
| 1437541190 | Keshawn Gardner | Specialist/Technologist, Other | 1248 Berry Ln, Flossmoor, IL 60422 | 2015-03-04 |
| 1770989717 | Naomi Kelly | Behavioral Analyst | 1930 Kedzie Avenue, Flossmoor, IL 60422 | 2014-11-18 |
| 1093059453 | Miranda Home Health Care Inc | In Home Supportive Care | 19150 S Kedzie Ave, 203, Flossmoor, IL 60422 | 2012-11-23 |
| 1285981506 | Restorative Life Services, LLC | Social Worker | 169624 Governors Highway, Flossmoor, IL 60422 | 2012-08-06 |
| 1063786457 | Gwyneeda Carter-sidberry | Pharmacist | 1443 Selkirk Street, Flossmoor, IL 60422 | 2012-03-02 |
| 1053682021 | Alfonso Javier Medina Sr. | Anesthesiology | 3141 Stonegate Ct., Flossmoor, IL 60422 | 2012-01-23 |
| 1912121161 | Anthony J Maoloni | Dentist | 19815 Governors Highway, Orthodontic Associates Ltd Suite 1, Flossmoor, IL 60422 | 2007-04-12 |
| Find all providers in zip 60422 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568991040 | Ni Van | Dentist | 19815 Governors Hwy Ste 7, Flossmoor, IL 60422-4388 | 2017-06-08 |
| 1023211844 | Stephen Edward Jarvie | Dentist | 19509 Governors Hwy, Flossmoor, IL 60422-2097 | 2007-06-08 |
| 1639383060 | Avery C. Powell | Dentist | 1719 Heather Hill Cres, Flossmoor, IL 60422-2041 | 2007-05-08 |
| 1982829255 | Daniel William Daly | Dentist | 1835 Dixie Hwy, Flossmoor, IL 60422-1974 | 2007-04-13 |
| 1740341973 | Charles J Greenebaum | Dentist | 19615 Governors Hwy, Flossmoor, IL 60422-2037 | 2006-12-12 |
| 1194811885 | Judy Ann Johnson, Dds, PC | Dentist | 1030 Sterling Avenue, Flossmoor, IL 60422-1265 | 2006-10-04 |
| 1245258318 | Kevin Lloyd Fatland | Dentist | 19509 Governor's Highway, Flossmoor, IL 60422-2097 | 2006-07-17 |
| 1740283605 | Richard J. Mantoan | Dentist | 19815 Governors Hwy, Ste 7, Flossmoor, IL 60422-4388 | 2005-05-24 |
| 1326457169 | Atdental LLC | Dentist | 19730 Governors Hwy, Suite 1, Flossmoor, IL 60422 | 2014-08-06 |
| 1598063885 | R.a. Berquist, D.d.s., P.C. | Dentist | 19710 Governors Hwy, Suite #4, Flossmoor, IL 60422-2080 | 2011-03-10 |
| Find all providers in FLOSSMOOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.