Individual provider Active NPI

Steven J Dana, D.D.S.

  • General Practice Dentistry
  • New Lenox, IL
National Provider Identifier
1194766410
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-016347 Issued in IL
Practice address
18906 Spring Creek St
New Lenox, IL 60451-9672
Phone
(708) 354-3135
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-016347 IL Primary

Addresses

Primary practice location

18906 Spring Creek St
New Lenox, IL 60451-9672

Mailing address

18906 Spring Creek St
New Lenox, IL 60451-9672
Phone (708) 354-3135

Other practice location 1

475 W 55th St
Suite 108
Countryside, IL 60525-3564
Phone (708) 354-3135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150624000795 IL Order and Referring Only - DentistPractitioner - Dentist 9335450840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1194766410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18906 SPRING CREEK ST",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519672",
            "telephone_number": "708-354-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18906 SPRING CREEK ST",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519672",
            "telephone_number": "708-354-3135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 W 55th St",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Countryside",
            "state": "IL",
            "postal_code": "605253564",
            "country_code": "US",
            "telephone_number": "708-354-3135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANA",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-016347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.