David Allen Wurzbach, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021530 Issued in IL

Practice address

310 Barron Blvd
Grayslake, IL 60030-1640

Phone

(847) 223-8100

Fax

(847) 223-8218

NPI assigned

May 23, 2005

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1417950403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 BARRON BLVD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301640",
            "telephone_number": "847-223-8100",
            "fax_number": "847-223-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BARRON BLVD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301640",
            "telephone_number": "847-223-8100",
            "fax_number": "847-223-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURZBACH",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gage Winters, DPM
• Griff J Winters, DPM
• Rebecca A Woeckel, OT
• Renae R. Woellert, B.S.
• Joanne Wong, PHARMD, RPH
• Kahoua Yang, MD
• Tracey Kaw Yu-Makeyev, LSW
• Liyuan Yu, M.D.
• Joyce L. Zablocki
• Zen Tantra Wellness Center

• General Practice Dentistry in Grayslake, IL
• Providers in Grayslake, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.