Irene Jovicic, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019029140 Issued in IL

Practice address

55 S Main St
Suite 241
Naperville, IL 60540-5372

Phone

(630) 848-2010

Fax

(630) 848-2011

NPI assigned

Jul 19, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Irina Pisareva Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1023363603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 ST ALBANS CIR",
            "address_2": "APT 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644818",
            "telephone_number": "847-452-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 S MAIN ST",
            "address_2": "SUITE 241",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405372",
            "telephone_number": "630-848-2010",
            "fax_number": "630-848-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOVICIC",
        "first_name": "IRENE",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRINA",
            "last_name": "PISAREVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Dentistry in Naperville, IL
• Providers in Naperville, 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 Feb 20, 2019; 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.