Active NPI
Maggie W Augustyn, DDS
- General Practice Dentistry
- Naperville, IL
National Provider Identifier
1073515193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19-026397
- Practice address
- 1304 Macom Dr
Naperville, IL 60564-9349 - Phone
- (630) 585-5005
- NPI assigned
- Jun 1, 2005
- Last updated
- Apr 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19-026397 | IL | Primary |
Addresses
Primary practice location
1304 Macom Dr
Naperville, IL 60564-9349
Mailing address
2244 S Elizabeth St
Lombard, IL 60148-7124
Phone (630) 361-4178
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19-026397 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1073515193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2244 S ELIZABETH ST",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601487124",
"telephone_number": "630-361-4178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 MACOM DR",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605649349",
"telephone_number": "630-585-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUGUSTYN",
"first_name": "MAGGIE",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-01",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "19-026397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.