Individual provider Active NPI

Gregory A Cygan, DDS

  • Dentist
  • Wheaton, IL
National Provider Identifier
1235575739
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019029409 Issued in IL
Practice address
610 W Roosevelt Rd Ste C1
Wheaton, IL 60187-2304
Phone
(630) 765-7557
NPI assigned
May 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12012816A IN
Dentist 122300000X 019029409 IL Primary

Addresses

Primary practice location

610 W Roosevelt Rd Ste C1
Wheaton, IL 60187-2304

Mailing address

610 W Roosevelt Rd Ste C1
Wheaton, IL 60187-2304
Phone (630) 765-7557

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190307001686 IL Order and Referring Only - DentistPractitioner - Dentist 3274835830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019029409ILMDDentist
12012816AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Surgeons LTD Dentist CurrentSince Feb 16, 2020 Accepting new patients

Locations

610 W Roosevelt Rd
Ste C1
Wheaton, IL 60187
Phone (630) 765-7557

Interoperability endpoints

  • Direct secure messaging: gregory.cygan.p1@direct.northshorehealth.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1368316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1235575739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W ROOSEVELT RD STE C1",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872304",
            "telephone_number": "630-765-7557",
            "fax_number": "630-581-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W ROOSEVELT RD STE C1",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872304",
            "telephone_number": "630-765-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYGAN",
        "first_name": "GREGORY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-12",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012816A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.