Matthew Mark Witkowski, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

021.003457 Issued in IL

Practice address

20 Executive CT Ste 1
South Barrington, IL 60010-9543

Phone

(847) 550-3460

NPI assigned

Feb 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Practice roles

Locations

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.

• BDD of Illinois P.C.

  dba AH Smiles

  • General Practice Dentistry
  • Arlington Heights, IL
  • NPI 1063183044

  Endodontics

  NPD

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1508366717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 RIVER WOODS DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605656356",
            "telephone_number": "313-407-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 EXECUTIVE CT STE 1",
            "city": "SOUTH BARRINGTON",
            "state": "IL",
            "postal_code": "600109543",
            "telephone_number": "847-550-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Newton Rd",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421001",
            "country_code": "US",
            "telephone_number": "319-335-7440",
            "fax_number": "319-335-7451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "313-407-6569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19615 Governors Hwy",
            "address_purpose": "LOCATION",
            "city": "Flossmoor",
            "state": "IL",
            "postal_code": "604222037",
            "country_code": "US",
            "telephone_number": "708-221-8343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITKOWSKI",
        "first_name": "MATTHEW",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-14",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019032088",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "RES-30652",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021.003457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shahen Yashpal, H.BSC, MSC., DDS
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• Endodontics in South Barrington, IL
• Providers in South Barrington, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.