Active NPI
Richard Robert Pellegrini, DDS
- General Practice Dentistry
- Joliet, IL
National Provider Identifier
1336258912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Practice address
- 801 N Larkin
Ste 105
Joliet, IL 60435-3442 - Phone
- (815) 744-3400
- Fax
- (815) 744-9925
- NPI assigned
- Aug 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Primary |
Addresses
Primary practice location
801 N Larkin
Ste 105
Joliet, IL 60435-3442
Mailing address
801 N Larkin
Ste 105
Joliet, IL 60435-3442
Phone (815) 744-3400
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019017251 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336258912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 N LARKIN",
"address_2": "STE 105",
"city": "JOLIET",
"state": "IL",
"postal_code": "604353442",
"telephone_number": "815-744-3400",
"fax_number": "815-744-9925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 N LARKIN",
"address_2": "STE 105",
"city": "JOLIET",
"state": "IL",
"postal_code": "604353442",
"telephone_number": "815-744-3400",
"fax_number": "815-744-9925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLEGRINI",
"first_name": "RICHARD",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Joliet, IL
- Pediatric Adult Rehabilitation Associates (Speech Tree)
- Pediatric Adult Rehabilitation Associates (PARA's Peach Tree)
- Scott Pedziwiatr
- Lydia Pelc, FNP-BC
- Bradley Pell, LAT
- Victoria Mary Pellettiere, PH.D.
- Nina Marie Pelsi, PA-C
- Schuyler A Perez de Salmeron, MSN APN ACCNS-AG
- Maria Perez
- Perioperative Nursing Associates
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.