NPIMap

Organization Active NPI

Dettmer & Bauer LLC

  • Dental Clinic/Center
  • Wheaton, IL
National Provider Identifier
1275848830
Registry record updated Aug 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019.014036 Issued in IL
Legal business name
DETTMER & BAUER LLC
Practice address
531 E Roosevelt Rd
Suite 100
Wheaton, IL 60187-5583
Phone
(630) 665-5550
Fax
(630) 665-5554
NPI assigned
Aug 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2010

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

Authorized official

Name
Dr. Martin A Dettmer, DDS
Title
President
Phone
(630) 665-5550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019.014036 IL Primary

Addresses

Primary practice location

531 E Roosevelt Rd
Suite 100
Wheaton, IL 60187-5583

Mailing address

531 E Roosevelt Rd
Suite 100
Wheaton, IL 60187-5583
Phone (630) 665-5550

National Provider Directory

National Provider Directory

Locations

531 E Roosevelt Rd
Ste 100
Wheaton, IL 60187
Phone (630) 665-5550

NPI Registry JSON

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

{
    "created_epoch": "1281139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281139200000",
    "number": "1275848830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 E ROOSEVELT RD",
            "address_2": "SUITE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875583",
            "telephone_number": "630-665-5550",
            "fax_number": "630-665-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 E ROOSEVELT RD",
            "address_2": "SUITE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875583",
            "telephone_number": "630-665-5550",
            "fax_number": "630-665-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETTMER & BAUER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-07",
        "last_updated": "2010-08-07",
        "status": "A",
        "authorized_official_last_name": "DETTMER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "16306655550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019.014036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2010; 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.