Scott Jeffrey Genutis, DDS,MS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Practice address

40W165 Campton Crossings Dr Ste B
Saint Charles, IL 60175-6570

Phone

(630) 513-6440

Fax

(630) 513-9377

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184744971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41W248 HEARTHSTONE CT",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601757876",
            "telephone_number": "630-939-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40W165 CAMPTON CROSSINGS DR STE B",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601756570",
            "telephone_number": "630-513-6440",
            "fax_number": "630-513-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENUTIS",
        "first_name": "SCOTT",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Saint Charles, IL
• Providers in Saint Charles, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.