NPIMap

Organization Active NPI

Michael R. Mazukelli, DDS, P.C.

  • General Practice Dentistry
  • Park Ridge, IL
National Provider Identifier
1235342064
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MICHAEL R. MAZUKELLI, DDS, P.C.
Practice address
954 N Northwest Hwy
Park Ridge, IL 60068-2358
Phone
(847) 823-4045
NPI assigned
May 8, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Michael MazukelliNPI 1386857191
Title
President
Phone
(847) 823-4045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

954 N Northwest Hwy
Park Ridge, IL 60068-2358

Mailing address

954 N Northwest Hwy
Park Ridge, IL 60068-2358

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1235342064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 N NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 N NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682358",
            "telephone_number": "847-823-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R. MAZUKELLI, DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MAZUKELLI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-823-4045"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.