Individual provider Active NPI

Dennis Engelmann, DDS

  • General Practice Dentistry
  • East Alton, IL
National Provider Identifier
1639224199
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
209 School St
East Alton, IL 62024-1458
Phone
(618) 254-0185
NPI assigned
Jan 24, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 IL Primary

Addresses

Primary practice location

209 School St
East Alton, IL 62024-1458

Mailing address

209 School St
East Alton, IL 62024-1458
Phone (618) 254-0185

Other identifiers 1

IdentifierTypeStateIssuer
101038MedicaidIL

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
019-014551ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pattan and Engelmann DDS LTD Past Accepting new patients
Pattan DDS Engelmann DDS LTD Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639224199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SCHOOL ST",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620241458",
            "telephone_number": "618-254-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SCHOOL ST",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620241458",
            "telephone_number": "618-254-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELMANN",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101038",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.