William Prosniewski, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019033158 Issued in IL

Practice address

116 W Bartlett Ave
Bartlett, IL 60103-4282

Phone

(630) 837-2779

NPI assigned

Jun 21, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1205405685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 LA COSTA AVE",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601036609",
            "telephone_number": "630-432-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W BARTLETT AVE",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034282",
            "telephone_number": "630-837-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSNIEWSKI",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverlee Jean Pomplun, M.A. CCC-SLP
• Loretta M. Pontes, LCSW
• Preeti Prashant, OTR/L
• Pres Physical Therapy
• Mark James Prosniewski, DDS
• Jennifer Provost
• Megan Quinn, LSW
• Radiant Home Health Care, Inc.
• Patricia Radley, MSW
• Khalil Rahman, PHARMD

• General Practice Dentistry in Bartlett, IL
• Providers in Bartlett, 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 Jun 21, 2021; 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.