Individual provider Active NPI

Robert H Dandino, D.D.S.

  • General Practice Dentistry
  • Waukegan, IL
National Provider Identifier
1578896718
Registry record updated Sep 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019022822 Issued in IL
Practice address
2504 Washington St.
Suite 500
Waukegan, IL 60085-4983
Phone
(847) 336-0700
Fax
(847) 336-5773
NPI assigned
Sep 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019022822 IL Primary

Addresses

Primary practice location

2504 Washington St.
Suite 500
Waukegan, IL 60085-4983

Mailing address

2504 Washington St.
Suite 500
Waukegan, IL 60085-4983
Phone (847) 336-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20150527001978 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8628398948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019022822ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Sarsha Williams Dandino & Assoc LTD General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252022400000",
    "number": "1578896718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 WASHINGTON ST.",
            "address_2": "SUITE 500",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854983",
            "telephone_number": "847-336-0700",
            "fax_number": "847-336-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 WASHINGTON ST.",
            "address_2": "SUITE 500",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854983",
            "telephone_number": "847-336-0700",
            "fax_number": "847-336-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDINO",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-04",
        "last_updated": "2009-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.