NPIMap

Organization Active NPI

Fox River Dental

  • General Practice Dentistry
  • Oswego, IL
National Provider Identifier
1194976209
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026849 Issued in IL
Legal business name
FOX RIVER DENTAL
Practice address
2968 Route 34
Oswego, IL 60543
Phone
(630) 554-9909
Fax
(630) 554-9909
NPI assigned
Oct 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Mrs. Subbashini Marimuthu, D.M.D
Title
President
Phone
(630) 554-9900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 019026849 IL Primary

Addresses

Primary practice location

2968 Route 34
Oswego, IL 60543

Mailing address

2968 Route 34
Oswego, IL 60543
Phone (630) 554-9909

National Provider Directory

National Provider Directory

Locations

2968 Route 34
Oswego, IL 60543
Phone (630) 554-9909

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1194976209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 ROUTE 34",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "60543",
            "telephone_number": "630-554-9909",
            "fax_number": "630-554-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 ROUTE 34",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "60543",
            "telephone_number": "630-554-9909",
            "fax_number": "630-554-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX RIVER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "MARIMUTHU",
        "authorized_official_first_name": "SUBBASHINI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-554-9900",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.