Dennis Dettmann, O.D. S.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007054 Issued in IL

Legal business name

DENNIS DETTMANN, O.D. S.C.

Practice address

21219 Silktree Cir
Plainfield, IL 60544-9359

Phone

(630) 257-6493

Fax

(630) 243-6293

NPI assigned

Sep 6, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Dennis E Dettmann, O.D.NPI 1609877455

Title

Owner

Phone

(630) 257-6493

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dennis E Dettmann, O.D.

  • Optometrist
  • Plainfield, IL
  • NPI 1609877455
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1265426217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21219 SILKTREE CIR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605449359",
            "telephone_number": "630-257-6493",
            "fax_number": "630-243-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21219 SILKTREE CIR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605449359",
            "telephone_number": "630-257-6493",
            "fax_number": "630-243-6293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS DETTMANN, O.D. S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "DETTMANN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-257-6493",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007054",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maureen Ochoa Dela Cruz, M.D.
• Maria Christine Deland
• Samantha Lisa Delaney
• Angelina J Delise
• Alexia Dellaca
• Dana Dennis, LPC
• Sara Kaitlyn Denova, LSW
• Dental Associates of Plainfield P.C.
• Dental Professionals of Illinois, P.C.
• Dental Shine II P.C

• Optometrist in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.