NPIMap

Organization Active NPI

Martin a. Dettmer, D.D.S.

  • Dental Clinic/Center
  • Wheaton, IL
National Provider Identifier
1346415783
Registry record updated Apr 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
19A14036 Issued in IL
Legal business name
MARTIN A. DETTMER, D.D.S.
Practice address
531 E Roosevelt Rd
Ste. 100
Wheaton, IL 60187-5583
Phone
(630) 665-5550
NPI assigned
Apr 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2008

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

Authorized official

Name
Dr. Martin A Dettmer, DDS
Title
Owner
Phone
(630) 665-5550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 19A14036 IL Primary

Addresses

Primary practice location

531 E Roosevelt Rd
Ste. 100
Wheaton, IL 60187-5583

Mailing address

531 E Roosevelt Rd
Ste. 100
Wheaton, IL 60187-5583
Phone (630) 665-5550

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1209254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209254400000",
    "number": "1346415783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 E ROOSEVELT RD",
            "address_2": "STE. 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875583",
            "telephone_number": "630-665-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 E ROOSEVELT RD",
            "address_2": "STE. 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875583",
            "telephone_number": "630-665-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN A. DETTMER, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-27",
        "last_updated": "2008-04-27",
        "status": "A",
        "authorized_official_last_name": "DETTMER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-665-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "19A14036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.