Mike Cvetkovic, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019019648 Issued in IL

Practice address

6686 Joliet Rd
Indian Head Park, IL 60525

Phone

(708) 783-1100

Fax

(708) 783-1101

NPI assigned

May 7, 2007

Last updated

Feb 3, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• D. Mike Cvetkovic, D.D.S., P.C.

  • Dental Clinic/Center
  • Countryside, IL
  • NPI 1942612965
  NPD (past)
• Robert J. Shanahan D.D.S., LTD.

  • General Practice Dentistry
  • Indian Head Park, IL
  • NPI 1366683898
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1114130051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6686 JOLIET RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605254575",
            "telephone_number": "708-783-1100",
            "fax_number": "708-783-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6686 JOLIET RD",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "60525",
            "telephone_number": "708-783-1100",
            "fax_number": "708-783-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CVETKOVIC",
        "first_name": "MIKE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019019648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briar Place, LTD. (Briar Place)
• Lea Brown, OTR/L
• Debra Lyne Bujalka, PHD, LCSW, PEL
• Carolyn Renee Bulmash, L.C.S.W.
• Deborah L Buscemi, LCSW
• Tiberiu Fulop, LAC
• Judith H Green, LCPC
• Spyridon Hasiakos, DMD
• Trudi Marie Kessler, PSYD
• Andrea Kovalsky

• General Practice Dentistry in Indian Head Park, IL
• Providers in Indian Head Park, 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 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.