Individual provider Active NPI

Dana Lipskis, DDS

  • Dentist
  • St Charles, IL
National Provider Identifier
1235547969
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019029970 Issued in IL
Practice address
516 E Main St
St Charles, IL 60174-2133
Phone
(630) 377-3131
Fax
(630) 377-3204
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019029970 IL Primary

Addresses

Primary practice location

516 E Main St
St Charles, IL 60174-2133

Mailing address

516 E Main St
St Charles, IL 60174-2133
Phone (630) 377-3131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150611000763 IL Order and Referring Only - Other (Non-Physician) 0749501054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019029970ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1235547969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E MAIN ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742133",
            "telephone_number": "630-377-3131",
            "fax_number": "630-377-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E MAIN ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742133",
            "telephone_number": "630-377-3131",
            "fax_number": "630-377-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSKIS",
        "first_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.