Frank Jerald Nustra, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19013658 Issued in IL

Practice address

1303 N Richmond Rd
McHenry, IL 60050-1405

Phone

(815) 385-8040

Fax

(815) 385-8040

NPI assigned

Jul 9, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1205099140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 N RICHMOND RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600501405",
            "telephone_number": "815-385-8040",
            "fax_number": "815-385-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 N RICHMOND RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600501405",
            "telephone_number": "815-385-8040",
            "fax_number": "815-385-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSTRA",
        "first_name": "FRANK",
        "middle_name": "JERALD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19013658",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "190-13658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Illinois Medical Center (Centegra Hospital McHenry)
• Northwest Interventional Specialists
• Northwest Testing LLC
• Notes to Self Counseling
• Alan H Numbers, D.P.M.
• Jennifer O'Connor
• Christopher Patrick O'Hara, MD
• Tara Jo O'Neill
• Diana Richelle O'Rourke
• Olabode O Obafemi

• General Practice Dentistry in McHenry, IL
• Providers in McHenry, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.