Maryann Hafezi, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025427 Issued in IL

Practice address

28365 Davis Pkwy
Ste 206
Warrenville, IL 60555

Phone

(630) 836-8995

NPI assigned

Aug 28, 2007

Last updated

Aug 28, 2007By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edp of Illinois P.C

  dba Affordable Dental of Illnois

  • Dental Clinic/Center
  • Dupo, IL
  • NPI 1154712784
  NPD (past)
• Family First Dental LLC

  • General Practice Dentistry
  • Warrenville, IL
  • NPI 1861553828
  NPD (past)

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1568656148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28365 DAVIS PARKWAY",
            "address_2": "FAMILY FIRST DENTAL LLC SUITE 206",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "60555",
            "telephone_number": "630-836-8995",
            "fax_number": "630-836-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28365 DAVIS PKWY",
            "address_2": "STE 206",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "60555",
            "telephone_number": "630-836-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEZI",
        "first_name": "MARYANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Grisch, RN
• Angela Gryzbek, M.S.N.
• Julia Guest, LSW
• Doug Guth, ATC
• Jennifer Gutke, LCPC
• Meghan Elizabeth Hanewall, PA-C
• Meghan C Hanrahan, ATC
• Dianne L Hanson, OT
• Pauline Harding, M.D.
• Ashley Nicole Hardy, M.D.

• General Practice Dentistry in Warrenville, IL
• Providers in Warrenville, 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 28, 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.