Michael Degould DDS PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

021001500 Issued in IL

Legal business name

MICHAEL DEGOULD DDS PC

Practice address

2835 McFarland Road
Suite C
Rockford, IL 61107

Phone

(815) 654-0039

Fax

(815) 654-0650

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael David Degould, DDS

Title

Oral Surgeon Owner

Phone

(815) 654-0039

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1346318532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 MCFARLAND ROAD",
            "address_2": "SUITE C",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61107",
            "telephone_number": "815-654-0039",
            "fax_number": "815-654-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 MCFARLAND ROAD",
            "address_2": "SUITE C",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61107",
            "telephone_number": "815-654-0039",
            "fax_number": "815-654-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL DEGOULD DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "DEGOULD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "ORAL SURGEON OWNER",
        "authorized_official_telephone_number": "815-654-0039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021001500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah D Meyers, PT
• Courtney Meza, APRN
• Eduardo D Meza, M.D.
• MH Health Care Services, PC
• MH Health Care Services, PC
• Michael S. Feldt, O.D., LTD.
• Brian Thomas Michalsen, D.O.
• Michael C Michelotti, MD
• Joseph Micho, MD
• Kelcy M Micklos

• Oral and Maxillofacial Surgery (Dentist) in Rockford, IL
• Providers in Rockford, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.