Gregory Paul Bobak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028992 Issued in IL

Practice address

230 E 8TH St
Suite C
Lockport, IL 60441-3081

Phone

(815) 838-6102

NPI assigned

Jun 7, 2012

Last updated

Jun 7, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1699037424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 8TH ST",
            "address_2": "SUITE C",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604413081",
            "telephone_number": "815-838-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 8TH ST",
            "address_2": "SUITE C",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604413081",
            "telephone_number": "815-838-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBAK",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Bevans
• Mark Warner Bey
• BH Care LLC
• Isabella Marie Bigos
• Margaret Mary Bitten, PTA
• Brianne Kathryn Boettcher
• Thomas Richard Brescia, D.C.
• Bridges to a New Day,NFP
• Brightpath Lab LLC
• Jennifer Britt, PARMD

• General Practice Dentistry in Lockport, IL
• Providers in Lockport, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.

Verify at the official NPI Registry.