Robert J Bacci, DDS
Individual provider Active NPI General Practice Dentistry · Carol Stream, IL
NPI 1275879405 · NPPES record last updated Dec 16, 2012
Key facts
- NPI
- 1275879405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019014514 (IL)
- Practice address
- 206 N Gary Ave
Carol Stream, IL 60188-1834 - Phone
- (630) 665-2147
- Fax
- (630) 665-6980
- NPI assigned
- Dec 16, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019014514 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dupage Dental Care Inc | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019014514 | IL | Yes |
Addresses
Primary practice location
206 N Gary Ave
Carol Stream, IL 60188-1834
Mailing address
206 N Gary Ave
Carol Stream, IL 60188-1834
Phone (630) 665-2147
Other providers in Carol Stream, IL
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- Athletic and Therapeutic Institute of Naperville LLC
- Audiologic Services, LTD.
- B & H Pharmacy Co
- Mark Babinski
- Aida Iris Bahena
- Stephen A. Baker
- Nicole M Barak
- Thea Isabel Barba
- Sharon Bartsch
All providers in Carol Stream, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2012. 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.