Philip Villejo Goduco, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

281 Evergreen Dr
Vernon Hills, IL 60061-2905

Phone

(847) 816-0463

Fax

(847) 816-0468

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

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.

• Goduco Family Dentistry, LTD.

  • Durable Medical Equipment & Medical Supplies
  • Vernon Hills, IL
  • NPI 1881826279

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225107642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 EVERGREEN DR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600612905",
            "telephone_number": "847-816-0463",
            "fax_number": "847-816-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 EVERGREEN DR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600612905",
            "telephone_number": "847-816-0463",
            "fax_number": "847-816-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODUCO",
        "first_name": "PHILIP",
        "middle_name": "VILLEJO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary S Giovannone, PH.D.
• Gita Physical Therapy PLLC
• Kari Lynn Glenn-Fitzgerald, MS
• Troy Lewis Glickstern, LPC
• Goduco Family Dentistry, LTD.
• Leslie Ann Golde, LCSW
• Michelle Lynn Goldstein
• Lisa M Goodson
• Sharon Ann Goodzey, DMD
• Tamara Gopal, LSW

• General Practice Dentistry in Vernon Hills, IL
• Providers in Vernon Hills, 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 8, 2007; 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.