John Mazzocco, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

019.036975 Issued in IL

Practice address

525 Tyler Rd
Saint Charles, IL 60174-3305

Phone

(630) 377-4677

NPI assigned

Nov 30, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1396511291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 TYLER RD",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601743305",
            "telephone_number": "630-362-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TYLER RD",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601743305",
            "telephone_number": "630-377-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOCCO",
        "first_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-30",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019.036975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgette Alexandra Maurino, LCSW
• Thomas Joseph Maurovich, DDS
• Melissa Elaine Mauthe, MSW, LCSW
• Brent Maxwell, D.C.
• Kylie Kathleen Maynard
• Lindsay McAndrews, LMFT
• Megan Jean McAvoy, PHARMD
• Anna McCaffrey, LCPC, NCC
• Diane Leone McCarthy, MA, CCC-SLP/L
• Megan McCollum

• Periodontics in Saint Charles, IL
• Providers in Saint Charles, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.