David Montgomery Abbott, D.D.S.
Individual provider Active NPI Dentist · Wheaton, IL
NPI 1114133733 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114133733
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 19016333 (IL)
- Practice address
- 108 Wakeman Ave
Wheaton, IL 60187-3662 - Phone
- (630) 668-5251
- Fax
- (630) 668-5485
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19016333 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diamantakos DDS Wheaton PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 19016333 | IL | Yes |
Addresses
Primary practice location
108 Wakeman Ave
Wheaton, IL 60187-3662
Mailing address
108 Wakeman Ave
Wheaton, IL 60187-3662
Phone (630) 668-5251
Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.