Bradley S Degroot, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019090200 Issued in IL

Practice address

1S224 Summit Ave
#205
Oakbrook Terrace, IL 60181-3983

Phone

(630) 627-3930

NPI assigned

Jun 27, 2012

Last updated

Jul 7, 2015By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1215291901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S224 SUMMIT AVE",
            "address_2": "#205",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813983",
            "telephone_number": "630-627-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S224 SUMMIT AVE",
            "address_2": "#205",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813983",
            "telephone_number": "630-627-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGROOT",
        "first_name": "BRADLEY",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019090200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Czuba, CCC-SLP
• Amin N Daghestani, MD
• Lauren Dalicandro, LCPC
• David C Chua, MD SC LTD (Summit Digestive and Liver Disease Specialists)
• Emily Davis, PA-C
• Dental Care of Oakbrook, P.C
• Dental Town
• Dermatology Associates of Oakbrook Terrace SC
• Ola D Dickens, RT
• Brenton Diers, LCSW

• Dentist in Oakbrook Terrace, IL
• Providers in Oakbrook Terrace, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.