Individual provider Active NPI

John Anthony Ranieri, D.D.S., M.S.

  • Dentist
  • Park Ridge, IL
National Provider Identifier
1205001989
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019017995 Issued in IL
Practice address
933 N Northwest Hwy
Park Ridge, IL 60068-5900
Phone
(847) 698-1177
Fax
(847) 698-1184
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019017995 IL Primary

Addresses

Primary practice location

933 N Northwest Hwy
Park Ridge, IL 60068-5900

Mailing address

933 N Northwest Hwy
Park Ridge, IL 60068-5900
Phone (847) 698-1177

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
I20150624000052 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4486965076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
019017995ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1205001989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600685900",
            "telephone_number": "847-698-1177",
            "fax_number": "847-698-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600685900",
            "telephone_number": "847-698-1177",
            "fax_number": "847-698-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANIERI",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019017995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.