Matthew B Sagun, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

021002492 Issued in IL

Practice address

450 Green Bay Rd
Kenilworth, IL 60043-1074

Phone

(847) 251-6228

NPI assigned

May 30, 2008

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

Credentials

Master of Science

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 and National Provider Directory roles.

• Lincoln Square Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1417559675
  NPD Authorized official
• Dana E. Fender, D.M.D., P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Champaign, IL
  • NPI 1346739372
  NPD (past)

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1144488651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 W IRVING PARK RD APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183874",
            "telephone_number": "847-668-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 GREEN BAY RD",
            "city": "KENILWORTH",
            "state": "IL",
            "postal_code": "600431074",
            "telephone_number": "847-251-6228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Meadow Rd",
            "address_2": "Ste. 306",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600623698",
            "country_code": "US",
            "telephone_number": "847-272-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAGUN",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026757",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Singh Paul
• Soultana Chatzopoulos Pope, DDS
• Seth Preminger, PSYD
• Cherry Ann Rivera, PT
• Hannah Dunn Rolighed
• Daniel Schaefer, MSW
• Elisabeth Schmidt
• Lauren Siegfried, MA
• Rebecca J Smith
• Claire Soch, PA

• Orthodontics and Dentofacial Orthopedics Dentistry in Kenilworth, IL
• Providers in Kenilworth, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.