NPIMap

Organization Active NPI

Angela Skidmore DDS PC

Doing business as Bartlett Dental Office

  • Dentist
  • Bartlett, IL
National Provider Identifier
1518375211
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019025896 Issued in IL
Legal business name
ANGELA SKIDMORE DDS PC
Doing business as
Bartlett Dental Office
Practice address
988 S Bartlett Rd
Bartlett, IL 60103-6500
Phone
(630) 289-4288
Fax
(630) 289-4468
NPI assigned
Jul 25, 2014
Last updated
Jul 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Authorized official

Name
Dr. Angela Bogacki Skidmore, D.D.S.NPI 1720072762
Title
President
Phone
(630) 289-4288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019025896 IL Primary

Addresses

Primary practice location

988 S Bartlett Rd
Bartlett, IL 60103-6500

Mailing address

988 S Bartlett Rd
Bartlett, IL 60103-6500
Phone (630) 289-4288

Other names 1

  • Bartlett Dental Office Doing business as

National Provider Directory

National Provider Directory

Locations

988 S Bartlett Rd
Bartlett, IL 60103
Phone (630) 289-4288

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406246400000",
    "number": "1518375211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 S BARTLETT RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601036500",
            "telephone_number": "630-289-4288",
            "fax_number": "630-289-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 S BARTLETT RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601036500",
            "telephone_number": "630-289-4288",
            "fax_number": "630-289-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA SKIDMORE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A",
        "authorized_official_last_name": "SKIDMORE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "BOGACKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-289-4288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bartlett Dental Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartlett, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.