NPIMap

Organization Active NPI

Associates for Oral Maxillofacial and Implant Surgery LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mount Prospect, IL
National Provider Identifier
1114911872
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ASSOCIATES FOR ORAL MAXILLOFACIAL AND IMPLANT SURGERY LTD
Practice address
10 N Ridge Ave
Mt Prospect, IL 60056-2428
Phone
(847) 255-7080
Fax
(847) 255-6931
NPI assigned
Sep 8, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dennis J Spinazze, DDSNPI 1457345217
Title
Oral Maxillofacial Surgeon
Phone
(847) 255-7080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X IL Primary

Addresses

Primary practice location

10 N Ridge Ave
Mt Prospect, IL 60056-2428

Mailing address

10 N Ridge Ave
Mt Prospect, IL 60056-2428
Phone (847) 255-7080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000226 IL Part B Supplier - Clinic/Group Practice 2365425469 Receives reassigned benefits from 4 practitioners
Practice locations: Bartlett, IL; Chicago, IL; Elk Grove Village, IL; Mount Prospect, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2056203Assocs for Oral, Maxillofacial and Implant Surgery10 N Ridge Ave, Mount Prospect, IL 60056Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

112 N Oak Ave
Bartlett, IL 60103
Phone (630) 289-5002

4935 W Irving Park Rd
Chicago, IL 60641
Phone (773) 736-3300

850 Biesterfield Rd
#3010
Elk Grove Vlg, IL 60007
Phone (847) 593-0535

850 Biesterfield Rd
Ste 3010
Elk Grove Vlg, IL 60007
Phone (847) 593-0535

10 N Ridge Ave
Mt Prospect, IL 60056
Phone (773) 736-3300

Practitioners & affiliated clinicians

Practitioners 9

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": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114911872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N RIDGE AVE",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562428",
            "telephone_number": "847-255-7080",
            "fax_number": "847-255-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N RIDGE AVE",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562428",
            "telephone_number": "847-255-7080",
            "fax_number": "847-255-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES FOR ORAL MAXILLOFACIAL AND IMPLANT SURGERY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPINAZZE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ORAL MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "847-255-7080",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.