Kevin Jack Otte, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19023277 Issued in IL

Practice address

Naval Health Clinic Great Lakes
Dental Directorate
North Chicago, IL 60088

Phone

(847) 688-5547

NPI assigned

Jan 12, 2006

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1477532968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NHCGL 3001A SIXTH STREET",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600880000",
            "telephone_number": "847-688-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC GREAT LAKES",
            "address_2": "DENTAL DIRECTORATE",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "60088",
            "telephone_number": "847-688-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTE",
        "first_name": "KEVIN",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19023277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilda Omeragic, RD, LDN
• Saji Oommen, M.D.,
• Alejandra Ruiz Ornelas, DDS
• Erika Osayande
• Anwar Alfredo Oshana, RPH
• Wendy Ottosen, RD, LDN
• Ashley Padgett, RN
• Erica Pagano, PTA
• Maddison Margaret Paladino
• Alina Pan, DDS

• General Practice Dentistry in North Chicago, IL
• Providers in North Chicago, 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 Nov 19, 2007; 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.