Active NPI
David Nelson Piper, D.M.D.
- Dentist
- Roscoe, IL
National Provider Identifier
1619303450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.029643
- Practice address
- 5647 Elevator Rd
Roscoe, IL 61073-8879 - Phone
- (815) 623-2300
- Fax
- (815) 623-6707
- NPI assigned
- Sep 25, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.029643 | IL | Primary |
Addresses
Primary practice location
5647 Elevator Rd
Roscoe, IL 61073-8879
Mailing address
5647 Elevator Rd
Roscoe, IL 61073-8879
Phone (815) 623-2300
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150522000551 | IL | Order and Referring Only - Other (Physician) | 9335469964 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.029643 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1619303450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5647 ELEVATOR RD",
"city": "ROSCOE",
"state": "IL",
"postal_code": "610738879",
"telephone_number": "815-623-2300",
"fax_number": "815-623-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5647 ELEVATOR RD",
"city": "ROSCOE",
"state": "IL",
"postal_code": "610738879",
"telephone_number": "815-623-2300",
"fax_number": "815-623-6707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIPER",
"first_name": "DAVID",
"middle_name": "NELSON",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-25",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.029643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roscoe, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.