Individual provider Active NPI

Joseph Brendan Baptist, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • River Forest, IL
National Provider Identifier
1407085053
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
019.027904 Issued in IL
Practice address
7603 North Ave
River Forest, IL 60305-1133
Phone
(708) 456-7787
NPI assigned
Jul 3, 2009
Last updated
Nov 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 019.027904 IL Primary

Addresses

Primary practice location

7603 North Ave
River Forest, IL 60305-1133

Mailing address

7603 North Ave
River Forest, IL 60305-1133
Phone (708) 456-7787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131004000086 IL Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 1456585504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.027904ILMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Dec 1, 2013 Accepting new patients
Loyola University Medical Center CurrentSince Dec 1, 2013 Accepting new patients
Midland Oral Surgery and Implant Centers, LTD Oral and Maxillofacial Surgery Past Accepting new patients
Cameo Endodontics, LTD Oral and Maxillofacial Surgery Past Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1407085053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7603 NORTH AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051133",
            "telephone_number": "708-456-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7603 NORTH AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051133",
            "telephone_number": "708-456-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAPTIST",
        "first_name": "JOSEPH",
        "middle_name": "BRENDAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-03",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.027904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Forest, IL

Sources for this page

Verify at the official NPI Registry.