John Allan Vravick, DDS MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

021001515 Issued in IL

Practice address

10 Phillip Road
Suite 112
Vernon Hills, IL 60061-1730

Phone

(847) 680-6900

Fax

(847) 680-6905

NPI assigned

Nov 21, 2006

Last updated

Feb 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Dental Associates LTD of Wisconsin

  • Endodontics
  • Wauwatosa, WI
  • NPI 1518266998
  Medicare reassignment
• Dental Assosiates

  • Dental Clinic/Center
  • Fond Du Lac, WI
  • NPI 1558710269
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1467527788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PHILLIP ROAD",
            "address_2": "SUITE 112",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611730",
            "telephone_number": "847-680-6900",
            "fax_number": "847-680-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PHILLIP ROAD",
            "address_2": "SUITE 112",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611730",
            "telephone_number": "847-680-6900",
            "fax_number": "847-680-6905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7117 Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531421450",
            "country_code": "US",
            "telephone_number": "262-942-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VRAVICK",
        "first_name": "JOHN",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "6313",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021001515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.