Individual provider Active NPI

Vincent Cosimo Vivirito, DDS

  • Dentist
  • Des Plaines, IL
National Provider Identifier
1386656437
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
1475 Oakton Street
Suite 3
Des Plaines, IL 60018
Phone
(847) 296-5166
Fax
(847) 296-5186
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

1475 Oakton Street
Suite 3
Des Plaines, IL 60018

Mailing address

1475 Oakton Street
Suite 3
Des Plaines, IL 60018
Phone (847) 296-5166

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
019013936ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386656437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 OAKTON STREET",
            "address_2": "SUITE 3",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "60018",
            "telephone_number": "847-296-5166",
            "fax_number": "847-296-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 OAKTON STREET",
            "address_2": "SUITE 3",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "60018",
            "telephone_number": "847-296-5166",
            "fax_number": "847-296-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVIRITO",
        "first_name": "VINCENT",
        "middle_name": "COSIMO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

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.

Verify at the official NPI Registry.