NPIMap

Individual provider Active NPI

Brian A. Zale, D.M.D.

  • General Practice Dentistry
  • Bourbonnais, IL
National Provider Identifier
1356542930
Registry record updated Jul 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-025386 Issued in IL
Practice address
498 Brown Blvd
Bourbonnais, IL 60914-2324
Phone
(815) 939-2520
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2008

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 019-025386 IL Primary

Addresses

Primary practice location

498 Brown Blvd
Bourbonnais, IL 60914-2324

Mailing address

2081 Calistoga Drive Suite 3 South
New Lenox, IL 60451
Phone (815) 462-4040

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

LicenseStateTypeSpecialty
019-025386ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Zale Family Dentistry, P.C. General Practice Past Accepting new patients
James Kent Guebert 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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215216000000",
    "number": "1356542930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 CALISTOGA DRIVE SUITE 3 SOUTH",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "815-462-4040",
            "fax_number": "815-462-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 BROWN BLVD",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142324",
            "telephone_number": "815-939-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALE",
        "first_name": "BRIAN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-025386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.