Kenneth Joseph Gregie, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19015201 Issued in IL

Practice address

413 W Saint Charles Rd
Villa Park, IL 60181-2432

Phone

(630) 629-3120

Fax

(630) 629-3167

NPI assigned

Nov 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alizan Dental LLC

  dba Handcrafted Smiles

  • Dental Clinic/Center
  • Villa Park, IL
  • NPI 1134969959
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023189404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 W SAINT CHARLES RD",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812432",
            "telephone_number": "630-629-3120",
            "fax_number": "630-629-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W SAINT CHARLES RD",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812432",
            "telephone_number": "630-629-3120",
            "fax_number": "630-629-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGIE",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19015201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Citlaly Gonzalez Davila, PSY D
• Claire Gornick
• Nicholas Vincent Gornick, PT, DPT
• Grace Counseling Center NFP
• Kylee Elizabeth Green
• Holly Catherine Guttersohn, DC
• Gwa Optical LLC
• Ginger L Hagen, MS, RD, LDN
• Alexa Marie Harper, PT, DPT
• Kristen Marie Harries

• General Practice Dentistry in Villa Park, IL
• Providers in Villa Park, 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 8, 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.