Marissa Dziepak, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

021002906 Issued in IL

Practice address

39 E Colorado Ave
Frankfort, IL 60423-1385

Phone

(708) 789-9289

NPI assigned

Jan 13, 2017

Last updated

Jan 3, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mdziepak284184@direct.myadvocateaurora.org

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.

• Dziepak DMD PLLC

  dba Little Roots Pediatric Dentistry

  • Pediatric Dentistry
  • Bartlett, IL
  • NPI 1407715345
  NPD Authorized official
• Dgbdds LLC, Denise Maniakouras, DDS

  dba Bite Size Pediatric Dentistry

  • Pediatric Dentistry
  • Frankfort, IL
  • NPI 1225402795
  NPD (past)

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1184160194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 SHAWNEE CT",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601032025",
            "telephone_number": "630-479-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 E COLORADO AVE",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231385",
            "telephone_number": "708-789-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIEPAK",
        "first_name": "MARISSA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021002906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Dudek
• Kristen Marie Dundee, L.C.P.C.
• Jennifer Duranceau
• Elizabeth Dvorkin, DPT
• Mary Elizabeth Dyer, MA, LCPC
• Tiara Eaton, LSW
• Stephanie Marie Edie, RN, PEL-CSN
• Edward J. Kirsch, D.D.S., P.C.
• Erik Eggert, DC
• Elite Ambulance Service Inc

• Pediatric Dentistry in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.