Active NPI
Justine Maria Bednarski, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1215429360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019034103
- Practice address
- 800 W Fulton St
Chicago, IL 60607 - Phone
- (847) 962-5175
- NPI assigned
- Jun 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN1857937 | MA | |
| Dentist | 122300000X | 019034103 | IL | Primary |
Addresses
Primary practice location
800 W Fulton St
Chicago, IL 60607
Mailing address
1856 Webster LN
Des Plaines, IL 60018-2059
Phone (847) 962-5175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019034103 | IL | MD | Dentist |
| DN1857937 | MA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mathew PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Attleboro, MA
- NPI 1023607041
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688688000000",
"number": "1215429360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1856 WEBSTER LN",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600182059",
"telephone_number": "847-962-5175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 W FULTON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60607",
"telephone_number": "847-962-5175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDNARSKI",
"first_name": "JUSTINE",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-05",
"last_updated": "2023-07-07",
"certification_date": "2023-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN1857937",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019034103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.