Individual provider Active NPI

Andrew Leon Bogdanowicz, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1114103041
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
7048 W Higgins Ave
Chicago, IL 60656-1977
Phone
(773) 775-7090
Fax
(773) 775-2858
NPI assigned
Jan 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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 IL Primary

Addresses

Primary practice location

7048 W Higgins Ave
Chicago, IL 60656-1977

Mailing address

7048 W Higgins Ave
Chicago, IL 60656-1977
Phone (773) 775-7090

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

LicenseStateTypeSpecialty
019019399ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1114103041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7048 W HIGGINS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561977",
            "telephone_number": "773-775-7090",
            "fax_number": "773-775-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7048 W HIGGINS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561977",
            "telephone_number": "773-775-7090",
            "fax_number": "773-775-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDANOWICZ",
        "first_name": "ANDREW",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.

Verify at the official NPI Registry.