Andrea Adam, DDS – Dentist in St Charles, IL

Key facts

NPI: 1255434700
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
Practice address: 40W320 Lafox Rd
Suite D
St Charles, IL 60175-6545
Phone: (630) 762-0000
Fax: (630) 762-9966
NPI assigned: Sep 7, 2006
Sex: Female
Sole proprietor: Yes

Organizations & group practices 2

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.

Teuscher Dental General Practice Dentistry · St Charles, IL · NPI 1053896183

NPD (past)
Teuscher Dental Group Dentist · St. Charles, IL · NPI 1225196173

NPD (past) DENTIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
019-019231	IL	MD	Dentist

Practice roles

Organization	Specialty	Status	New patients
Teuscher Dental		Past	Accepting new patients
Teuscher Dental Group	Dentist	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X		IL	Yes

Addresses

Primary practice location

40W320 Lafox Rd
Suite D
St Charles, IL 60175-6545

Mailing address

40W320 Lafox Rd
Suite D
St Charles, IL 60175-6545
Phone (630) 762-0000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255434700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40W320 LAFOX RD",
            "address_2": "SUITE D",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601756545",
            "telephone_number": "630-762-0000",
            "fax_number": "630-762-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40W320 LAFOX RD",
            "address_2": "SUITE D",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601756545",
            "telephone_number": "630-762-0000",
            "fax_number": "630-762-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAM",
        "first_name": "ANDREA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

All providers in St Charles, IL · Dentist in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.