Robert C Dillman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3509 Issued in WI

Practice address

851 Park Dr
Suite 101
Lake Geneva, WI 53147-4586

Phone

(262) 248-4991

Fax

(262) 248-0397

NPI assigned

Nov 17, 2006

Sex

Male

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

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Geneva Family Dentistry

  • General Practice Dentistry
  • Lake Geneva, WI
  • NPI 1205900586
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184798829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 PARK DR",
            "address_2": "SUITE 101",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474586",
            "telephone_number": "262-248-4991",
            "fax_number": "262-248-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 PARK DR",
            "address_2": "SUITE 101",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474586",
            "telephone_number": "262-248-4991",
            "fax_number": "262-248-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLMAN",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anastasia S Demco
• Brianna Depietro, DPT
• Julia R Dewey, M.D.
• Tina Marie Dewing, RN
• Crystal J Dillett, NP
• Direct Medical Access Services
• John Michael Disabato Jr.
• Discovering Pathways Inc
• Millicent Joanna Doud, NURSE PRACTITIONER
• Madalyn R Douglas, DPT

• General Practice Dentistry in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.