Frederick P Waldschmidt, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-019355 Issued in IL

Practice address

750 Almar Pkwy
Suite 101
Bourbonnais, IL 60914-2315

Phone

(815) 932-5221

Fax

(815) 932-5269

NPI assigned

Feb 28, 2011

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

State licenses

Practice roles

Locations

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

• Frederick P Waldschmidt D D S P C

  • Dentist
  • Bourbonnais, IL
  • NPI 1780758193
  NPD Authorized official
• Aoam Dental LLC

  • General Practice Dentistry
  • Bourbonnais, IL
  • NPI 1184547275
  NPD (past)

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1114225141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 ALMAR PKWY",
            "address_2": "SUITE 101",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142315",
            "telephone_number": "815-932-5221",
            "fax_number": "815-932-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ALMAR PKWY",
            "address_2": "SUITE 101",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142315",
            "telephone_number": "815-932-5221",
            "fax_number": "815-932-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDSCHMIDT",
        "first_name": "FREDERICK",
        "middle_name": "P",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-28",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-019355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vishwam, Inc
• Vishwam, Inc
• Vitality Family Medical & Wellness PLLC
• Vna Home Health of Illinois LTD
• Suresh H Wadhwani, M.D. S.C.
• Walgreen Co
• Walgreen Co.
• Dalene Wallace
• Walmart Inc.
• Kellee J Ward, LCSW

• General Practice Dentistry in Bourbonnais, IL
• Providers in Bourbonnais, 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 Apr 21, 2015; 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.