NAPERVILLE DENTAL GROUP (NPI# 1669865135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669865135 |
| Entity Type | Organization |
| Organization Name | NAPERVILLE DENTAL GROUP |
| Practice Address |
1020 E Ogden Ave Suite 308 Naperville IL 60563-8609 |
| Practice Telephone | 6305270544 |
| Practice Fax Number | 6305272433 |
| Mailing Telephone | 6305270544 |
| Mailing Fax Number | 6305272433 |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |
| Authorized Official Name | DR. KENNETH R. PICKETT (PRESIDENT/BUSINESS OWNER) |
| Authorized Official Telephone | 6305270544 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 019.017904 | IL | Dental Providers |
| N | 122300000X | Dentist | 019.029826 | IL | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
019.029826 | IL | Dental Providers |
| N | 1223P0300X |
Dentist Specialization: Periodontics |
021.001252 | IL | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.017904 | IL | Dental Providers |
| Street Address |
1020 E OGDEN AVE SUITE 308 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60563-8609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740281054 | Michael W Boettcher | Pediatrics | 1020 E Ogden Ave, Ste 201, Naperville, IL 60563-8609 | 2005-08-09 |
| 1679087340 | Amy Pearson Nichols | Counselor | 1020 E Ogden Ave, Naperville, IL 60563-8609 | 2017-11-16 |
| 1326314246 | George C Pontikis | Surgery | 1020 E Ogden Ave, Naperville, IL 60563-8609 | 2012-03-25 |
| 1083991939 | Christine M Sutton | Physician Assistant | 1020 E Ogden Ave, Ste 115, Naperville, IL 60563 | 2011-11-07 |
| 1023391844 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 1020 E Ogden Ave, Ste 301, Naperville, IL 60563-8609 | 2011-09-28 |
| 1275816027 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 1020 E Ogden Ave, Ste 102, Naperville, IL 60563 | 2011-09-27 |
| 1083993752 | Edith Pignotti | Dietitian, Registered | 1020 E Ogden Ave, 304, Naperville, IL 60563-8609 | 2011-08-11 |
| 1528353034 | Hina Shaukat Chaudhry | Internal Medicine | 1020 E Ogden Ave, Ste 100, Naperville, IL 60563-8609 | 2011-06-13 |
| 1962701342 | Tobby Mathew | Internal Medicine | 1020 E Ogden Ave, Naperville, IL 60563-8609 | 2011-03-24 |
| 1194037382 | Siya Ann Nedumgottil | Internal Medicine | 1020 E Ogden Ave, Ste 115, Naperville, IL 60563-8609 | 2010-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1700484847 | Lee Michael Harms I | Social Worker | 1952 Mcdowell Road, Suite 305, Naperville, IL 60563 | 2020-10-12 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1851901219 | Adiana Lebron | Social Worker | 2948 Artestian Road, Naperville, IL 60563 | 2020-07-31 |
| 1194342014 | Ingrid Lara | Behavioral Analyst | 1975 Mcdowell Rd #101, Naperville, IL 60563 | 2020-06-26 |
| 1396383030 | Jack Kelly | Assistant Behavior Analyst | 1975 Mcdowell Rd. #101, Naperville, IL 60563 | 2019-12-12 |
| 1316583529 | Arvind Ramakrishnan | Behavioral Analyst | 1975 Mcdowell Rd., Naperville, IL 60563 | 2019-11-22 |
| 1679115778 | Melissa Macias | Behavioral Analyst | 1975 Mcdowell Road, #101, Naperville, IL 60563 | 2019-10-10 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| Find all providers in zip 60563 | ||||
| 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 |
|---|---|---|---|---|
| 1801403555 | Stephanie Elizabeth Miller | Dentist | 2220 Sisters Ave, Naperville, IL 60564-4394 | 2020-09-27 |
| 1417564121 | Gursimran Reen, Dmd LLC | Dentist | 29 S Webster St Ste 108, Naperville, IL 60540-5353 | 2020-09-26 |
| 1023631611 | Conor Patrick Ryan | Dentist | 1852 Bay Scott Cir Ste 108, Naperville, IL 60540-1134 | 2020-05-18 |
| 1629614698 | Ashton Dental PC | Dentist | 1767 W Ogden Ave Ste 123, Naperville, IL 60540-3956 | 2019-11-25 |
| 1396390340 | Lina Hamdan | Dentist | 603 Arlington Ave, Naperville, IL 60565-3399 | 2019-08-06 |
| 1376050245 | Zieba Dentistry Naperville, Ltd | Dentist | 24w500 Maple Ave Ste 218, Naperville, IL 60540-6057 | 2018-01-02 |
| 1811413719 | Cap Dental Care P.C. | Dentist | 555 N Washington St., Naperville, IL 60563 | 2017-08-22 |
| 1366991655 | Valley View Dental - Naperville P.C. | Dentist | 3103 111th St Ste 131, Naperville, IL 60564-5068 | 2016-09-27 |
| 1790149631 | Stephanie Cravens | Dentist | 2776 Forgue Dr, Suite 106, Naperville, IL 60564-4175 | 2016-04-06 |
| 1457744963 | Sun Dental Care PC | Dentist | 572 Weston Ridge Dr, Suite# 120, Naperville, IL 60563-4109 | 2015-03-07 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60563 |
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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.