Lisa Ann Ciucci O'Grady, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019023659 Issued in IL

Practice address

1216 N Division St
Morris, IL 60450

Phone

(815) 941-4343

Fax

(815) 942-8414

NPI assigned

Nov 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Lisa A Ciucci Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1306026372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 N DIVISION ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-941-4343",
            "fax_number": "815-942-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 N DIVISION ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-941-4343",
            "fax_number": "815-942-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIUCCI O'GRADY",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CIUCCI",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Morris, IL
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.