Individual provider Active NPI

Paul L. Engen, DDS

  • General Practice Dentistry
  • Elgin, IL
National Provider Identifier
1295810836
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019018358 Issued in IL
Practice address
16 N Airlite St
Suite 2
Elgin, IL 60123-4969
Phone
(847) 742-1700
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019018358 IL Primary

Addresses

Primary practice location

16 N Airlite St
Suite 2
Elgin, IL 60123-4969

Mailing address

16 N Airlite St
Suite 2
Elgin, IL 60123-4969
Phone (847) 742-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702000083 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9931411030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019018358ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Varma Dental PC PastSince Sep 20, 2022 Accepting new patients
Paul L. Engen DDS PC General Practice 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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1295810836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N AIRLITE ST",
            "address_2": "SUITE 2",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234969",
            "telephone_number": "847-742-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N AIRLITE ST",
            "address_2": "SUITE 2",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234969",
            "telephone_number": "847-742-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEN",
        "first_name": "PAUL",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019018358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.