Individual provider Active NPI

William Just Bleecker, DDS

  • Dentist
  • Naperville, IL
National Provider Identifier
1669553269
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
552 South Washington Street
Suite 105
Naperville, IL 60540-6669
Phone
(630) 355-3556
Fax
(630) 355-5492
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

552 South Washington Street
Suite 105
Naperville, IL 60540-6669

Mailing address

552 South Washington Street
Suite 105
Naperville, IL 60540-6669
Phone (630) 355-3556

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
019014018ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669553269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 SOUTH WASHINGTON STREET",
            "address_2": "SUITE 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406669",
            "telephone_number": "630-355-3556",
            "fax_number": "630-355-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 SOUTH WASHINGTON STREET",
            "address_2": "SUITE 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406669",
            "telephone_number": "630-355-3556",
            "fax_number": "630-355-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEECKER",
        "first_name": "WILLIAM",
        "middle_name": "JUST",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.