Active NPI
Richard Jude Osmanski, D.D.S.
- General Practice Dentistry
- Crystal Lake, IL
National Provider Identifier
1629243076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019021692
- Practice address
- 77 E Crystal Lake Ave
Crystal Lake, IL 60014-6171 - Phone
- (815) 459-8650
- Fax
- (815) 455-9503
- NPI assigned
- Apr 28, 2008
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019021692 | IL | Primary |
Addresses
Primary practice location
77 E Crystal Lake Ave
Crystal Lake, IL 60014-6171
Mailing address
6 Laurel Valley Court
Lake in the Hills, IL 60156
Phone (847) 854-7806
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019021692 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard J Osmanski, DDS PC | 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.
-
- General Practice Dentistry
- Crystal Lake, IL
- NPI 1346415924
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209340800000",
"number": "1629243076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 LAUREL VALLEY COURT",
"city": "LAKE IN THE HILLS",
"state": "IL",
"postal_code": "60156",
"telephone_number": "847-854-7806",
"fax_number": "847-854-7806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 E CRYSTAL LAKE AVE",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600146171",
"telephone_number": "815-459-8650",
"fax_number": "815-455-9503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSMANSKI",
"first_name": "RICHARD",
"middle_name": "JUDE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-28",
"last_updated": "2008-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019021692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.