Individual provider Active NPI

Joseph Daniel Maggio

  • Endodontics
  • Lisle, IL
National Provider Identifier
1568577815
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
02100717 Issued in IL
Practice address
6448 College Road
Lisle, IL 60532-3290
Phone
(630) 548-1324
Fax
(630) 548-1358
NPI assigned
Aug 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 02100717 IL Primary

Addresses

Primary practice location

6448 College Road
Lisle, IL 60532-3290

Mailing address

6448 College Road
Lisle, IL 60532-3290
Phone (630) 548-1324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02100717ILMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568577815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6448 COLLEGE ROAD",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323290",
            "telephone_number": "630-548-1324",
            "fax_number": "630-548-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6448 COLLEGE ROAD",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323290",
            "telephone_number": "630-548-1324",
            "fax_number": "630-548-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGIO",
        "first_name": "JOSEPH",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "02100717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.