NPIMap

Organization Active NPI

Artisan Dental Group - Richard Maddalozzo DDS Ms LLC

  • Dentist
  • Palatine, IL
National Provider Identifier
1255879946
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019021223 Issued in IL
Legal business name
ARTISAN DENTAL GROUP - RICHARD MADDALOZZO DDS MS LLC
Practice address
649 N 1St Bank Dr
Palatine, IL 60067-8111
Phone
(847) 934-4280
Fax
(847) 934-4294
NPI assigned
Feb 2, 2017
Last updated
Feb 2, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ARTISAN DENTAL GROUP OF ILLINOIS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Authorized official

Name
Dr. Richard Maddalozzo, D.D.S., M.S.NPI 1942612320
Title
Member
Phone
(847) 934-4280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019021223 IL Primary
General Practice Dentistry 1223G0001X 019021223 IL
Periodontics 1223P0300X 021001510 IL

Addresses

Primary practice location

649 N 1St Bank Dr
Palatine, IL 60067-8111

Mailing address

649 N 1St Bank Dr
Palatine, IL 60067-8111
Phone (847) 934-4280

National Provider Directory

National Provider Directory
Part of
Artisan Dental Group of Illinois LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1255879946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 N 1ST BANK DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678111",
            "telephone_number": "847-934-4280",
            "fax_number": "847-934-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 N 1ST BANK DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678111",
            "telephone_number": "847-934-4280",
            "fax_number": "847-934-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTISAN DENTAL GROUP - RICHARD MADDALOZZO DDS MS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARTISAN DENTAL GROUP OF ILLINOIS LLC",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "MADDALOZZO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-934-4280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019021223",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021223",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021001510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.