Individual provider Active NPI

Robert F. Dutka, ROBERT DUTKA D.D.S.

  • Dentist
  • Arlington Heights, IL
National Provider Identifier
1619122579
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
A13591 Issued in IL
Practice address
615 W Euclid Ave
Arlington Heights, IL 60004-5301
Phone
(847) 577-4444
Fax
(847) 577-4463
NPI assigned
Nov 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X A13591 IL Primary

Addresses

Primary practice location

615 W Euclid Ave
Arlington Heights, IL 60004-5301

Mailing address

615 W Euclid Ave
Arlington Heights, IL 60004-5301
Phone (847) 577-4444

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A13591ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1619122579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W EUCLID AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600045301",
            "telephone_number": "847-577-4444",
            "fax_number": "847-577-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W EUCLID AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600045301",
            "telephone_number": "847-577-4444",
            "fax_number": "847-577-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTKA",
        "first_name": "ROBERT",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "ROBERT DUTKA  D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "A13591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.