John Thomas Maffeo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019017644 Issued in IL

Practice address

3450 Lacey Rd
Downers Grove, IL 60515-5430

Phone

(630) 743-4500

Fax

(630) 743-4537

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Apr 18, 2019 through Apr 18, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jmaffeo18535@direct.midwestern.edu

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1598834475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500",
            "fax_number": "630-743-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500",
            "fax_number": "630-743-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAFFEO",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019017644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.