Jackie Garcia, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-027578 Issued in IL

Practice address

290 Springfield Dr
Suite 100
Bloomingdale, IL 60108-2214

Phone

(630) 529-0027

Fax

(630) 529-0068

NPI assigned

Jul 17, 2008

Sex

Female

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Jun 28, 2017 through Jun 28, 2027

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Elmhurst Dental Group, LTD Dba Bloomingdale Dental

  • General Practice Dentistry
  • Bloomingdale, IL
  • NPI 1871826438
  NPD (past)

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1508020660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 SPRINGFIELD DR",
            "address_2": "SUITE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082214",
            "telephone_number": "630-529-0027",
            "fax_number": "630-529-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 SPRINGFIELD DR",
            "address_2": "SUITE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082214",
            "telephone_number": "630-529-0027",
            "fax_number": "630-529-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JACKIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-027578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rex Limon Gamisera, PT, DPT
• Perry Wilson Gamon, PTA
• Khushabu Gandhi, NP-C
• Krystian Garbicz, DC
• Ana Lilia Garcia
• Toni Gary, LPC
• Gina Gattuso, LCSW
• Genlab Corporation
• Genlab Corporation
• Angelo Georgacopoulos, LCPC

• General Practice Dentistry in Bloomingdale, IL
• Providers in Bloomingdale, 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 Aug 12, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.