Individual provider Active NPI

Richard W Ziegler, D.D.S.

  • Dentist
  • Berwyn, IL
National Provider Identifier
1265473938
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-019096 Issued in IL
Practice address
6903 Stanley Ave
Berwyn, IL 60402-2919
Phone
(708) 795-4288
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019-019096 IL Primary

Addresses

Primary practice location

6903 Stanley Ave
Berwyn, IL 60402-2919

Mailing address

6903 Stanley Ave
Berwyn, IL 60402-2919
Phone (708) 795-4288

Other practice location 1

3218 Kenilworth Ave
Berwyn, IL 60402-3003
Phone (708) 637-6997

Other identifiers 2

IdentifierTypeStateIssuer
319-008545OtherILCS LICENSE
019-019096MedicaidIL

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019-019096ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Ziegler DDS, PC Past Accepting new patients
Smiles of Hope Incorporated Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265473938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6903 STANLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022919",
            "telephone_number": "708-795-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6903 STANLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022919",
            "telephone_number": "708-795-4288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3218 Kenilworth Ave",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023003",
            "country_code": "US",
            "telephone_number": "708-637-6997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIEGLER",
        "first_name": "RICHARD",
        "middle_name": "W",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-019096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CS LICENSE",
            "identifier": "319-008545",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019-019096",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.