Individual provider Active NPI

Rebecca J. Testa, D.D.S

  • Pediatric Dentistry
  • Flossmoor, IL
National Provider Identifier
1194945667
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
019027373 Issued in IL
Practice address
19815 Governors Hwy
Suite # 4
Flossmoor, IL 60422-4385
Phone
(708) 814-5783
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 019027373 IL Primary

Addresses

Primary practice location

19815 Governors Hwy
Suite # 4
Flossmoor, IL 60422-4385

Mailing address

19815 Governors Hwy
Suite # 4
Flossmoor, IL 60422-4385
Phone (708) 814-5783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019027373ILMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca Testa Pediatric Dental Specialist PLLC Pediatric Dentistry CurrentSince Mar 13, 2022 Accepting new patients

Locations

19815 Governors Hwy
Ste 4
Flossmoor, IL 60422
Phone (708) 799-5437

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1194945667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19815 GOVERNORS HWY",
            "address_2": "SUITE # 4",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604224385",
            "telephone_number": "708-814-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19815 GOVERNORS HWY",
            "address_2": "SUITE # 4",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604224385",
            "telephone_number": "708-814-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESTA",
        "first_name": "REBECCA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019027373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flossmoor, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.