Individual provider Active NPI

Richard A Munaretto, D.D.S., M.S.

  • Endodontics
  • River Forest, IL
National Provider Identifier
1124097654
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
21-001023 Issued in IL
Practice address
7603 North Ave
Suite #202
River Forest, IL 60305-1133
Phone
(708) 456-7787
Fax
(708) 689-0853
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19-013654 IL
Endodontics 1223E0200X 21-001023 IL Primary

Addresses

Primary practice location

7603 North Ave
Suite #202
River Forest, IL 60305-1133

Mailing address

7603 North Ave
River Forest, IL 60305-1133
Phone (708) 456-7787

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
19-013654ILMDDentist
21-001023ILMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Cameo Endodontics, LTD Endodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1124097654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7603 NORTH AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051133",
            "telephone_number": "708-456-7787",
            "fax_number": "708-689-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7603 NORTH AVE",
            "address_2": "SUITE #202",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051133",
            "telephone_number": "708-456-7787",
            "fax_number": "708-689-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNARETTO",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19-013654",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "21-001023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.