Wayne M Mrjenovich DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WAYNE M MRJENOVICH DDS PC

Practice address

19111 Burnham Ave
Lansing, IL 60438

Phone

(708) 895-0500

Fax

(708) 895-7700

NPI assigned

Dec 6, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Wayne Michael Mrjenovich, DDS

Title

President

Phone

(708) 895-0500

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1013076348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19111 BURNHAM AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "60438",
            "telephone_number": "708-895-0500",
            "fax_number": "708-895-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19111 BURNHAM AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "60438",
            "telephone_number": "708-895-0500",
            "fax_number": "708-895-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE M MRJENOVICH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "MRJENOVICH",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-895-0500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lansing, IL
• Providers in Lansing, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.