Bryan Bauer, D.D.S.
Individual provider Active NPI General Practice Dentistry · Wheaton, IL
NPI 1467583161 · NPPES record last updated May 24, 2012
Key facts
- NPI
- 1467583161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019026380 (IL)
- Practice address
- 531 E Roosevelt Rd
Suite 100
Wheaton, IL 60187-5583 - Phone
- (630) 665-5550
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150327002271 | IL | Order and Referring Only - Dentist |
0143547265 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bauer Dental and Orthodontics LTD | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019026380 | IL | Yes |
Addresses
Primary practice location
531 E Roosevelt Rd
Suite 100
Wheaton, IL 60187-5583
Mailing address
1547 Orchard Rd
Wheaton, IL 60189-7201
Phone (312) 371-6831
Other providers in Wheaton, IL
- Deborah Bates
- Patricia Bates
- Earvin Batitang
- Sherry Batteast
- Bauer Dental and Orthodontics LTD
- Laura A. Bauhof
- Lindsay Noel Baumgartner
- Nina Francesca Bazzanella
- Jane Beal
- Dennis James Beck
All providers in Wheaton, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.