Individual provider Active NPI

Scott R Dykes, D.D.S.

  • General Practice Dentistry
  • Winfield, IL
National Provider Identifier
1043405855
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19-019872 Issued in IL
Practice address
27W281 Geneva Rd
Suite E
Winfield, IL 60190-2035
Phone
(630) 690-3554
Fax
(630) 690-9780
NPI assigned
Sep 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19-019872 IL Primary

Addresses

Primary practice location

27W281 Geneva Rd
Suite E
Winfield, IL 60190-2035

Mailing address

27W281 Geneva Rd
Suite E
Winfield, IL 60190-2035
Phone (630) 690-3554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160210000091 IL Order and Referring Only - DentistPractitioner - Dentist 9234433376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19-019872ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1043405855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27W281 GENEVA RD",
            "address_2": "SUITE E",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601902035",
            "telephone_number": "630-690-3554",
            "fax_number": "630-690-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27W281 GENEVA RD",
            "address_2": "SUITE E",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601902035",
            "telephone_number": "630-690-3554",
            "fax_number": "630-690-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKES",
        "first_name": "SCOTT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19-019872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.