Gabriel Kosmalski, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019035613 Issued in IL

Practice address

12200 Western Ave Ste 108
Blue Island, IL 60406-1493

Phone

(708) 385-3700

NPI assigned

May 15, 2024

Last updated

Nov 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Dental Experts, LLC

  • General Practice Dentistry
  • Blue Island, IL
  • NPI 1154592145
  NPD (past)

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1144079823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6953 HILLCREST AVE",
            "city": "RUDOLPH",
            "state": "WI",
            "postal_code": "544759516",
            "telephone_number": "715-347-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 WESTERN AVE STE 108",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604061493",
            "telephone_number": "708-385-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMALSKI",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "600170215",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019035613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Kevin Kirkwood, D.O.
• Steven Kluck, PA-C
• Sandra Cecilia Knox, L.C.P.C.
• Jennifer R. Komada, NP-C
• Kathleen J Korman
• Meghan Kosman
• Daniel R Kowalzyk, DO
• Kathryn K Kunz, RDLDN
• Jehan Kuri
• Elissa Kurz

• General Practice Dentistry in Blue Island, IL
• Providers in Blue Island, 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 Nov 20, 2024; 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.