Active NPI
Dennis Allen Runyan, DDS
- Prosthodontics
- Great Lakes, IL
National Provider Identifier
1659346328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 5778
- Practice address
- Great Lakes Naval Training Center
Great Lakes, IL 60088 - Phone
- (847) 688-7373
- NPI assigned
- Feb 17, 2006
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 5778 | WI | Primary |
Addresses
Primary practice location
Great Lakes Naval Training Center
Great Lakes, IL 60088
Mailing address
8714 245TH Ave
Salem, WI 53168-9085
Phone (847) 769-3446
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 |
|---|---|---|---|
| 5778 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1659346328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8714 245TH AVE",
"city": "SALEM",
"state": "WI",
"postal_code": "531689085",
"telephone_number": "847-769-3446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "GREAT LAKES NAVAL TRAINING CENTER",
"city": "GREAT LAKES",
"state": "IL",
"postal_code": "60088",
"telephone_number": "847-688-7373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNYAN",
"first_name": "DENNIS",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "WI",
"license": "5778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Lakes, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.