Organization Active NPI

Ann E. Mazzotti, D.D.S.,P.C.

  • General Practice Dentistry
  • Homewood, IL
National Provider Identifier
1073750402
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.021636 Issued in IL
Legal business name
ANN E. MAZZOTTI, D.D.S.,P.C.
Practice address
18650 Dixie Hwy
Homewood, IL 60430-3700
Phone
(708) 798-4424
Fax
(708) 798-7233
NPI assigned
Jan 7, 2009
Last updated
Jan 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Authorized official

Name
Dr. Ann E. Mazzotti, D.D.S.,P.C.NPI 1972551737
Title
Dentist/Owner
Phone
(708) 798-4424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019.021636 IL Primary

Addresses

Primary practice location

18650 Dixie Hwy
Homewood, IL 60430-3700

Mailing address

18650 Dixie Hwy
Homewood, IL 60430-3700
Phone (708) 798-4424

National Provider Directory

National Provider Directory

Locations

18650 Dixie Hwy
Homewood, IL 60430
Phone (708) 315-2764

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1073750402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18650 DIXIE HWY",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303700",
            "telephone_number": "708-798-4424",
            "fax_number": "708-798-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18650 DIXIE HWY",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303700",
            "telephone_number": "708-798-4424",
            "fax_number": "708-798-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN E. MAZZOTTI, D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "MAZZOTTI",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "708-798-4424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S.,P.C."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.021636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.