NPIMap

Individual provider Active NPI

David Joseph Rubis, D.D.S.

  • Dentist
  • Crest Hill, IL
National Provider Identifier
1699873588
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-016447 Issued in IL
Practice address
2241 Theodore St
Crest Hill, IL 60435-1881
Phone
(815) 741-1700
NPI assigned
Sep 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 019-016447 IL Primary

Addresses

Primary practice location

2241 Theodore St
Crest Hill, IL 60435-1881

Mailing address

2241 Theodore St
Crest Hill, IL 60435-1881
Phone (815) 741-1700

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-016447ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Family Dental and Orthodontics, P.C. Dentist Past Accepting new patients
Advanced Family Dental & Orthodontics Past Accepting new patients
Advanced Fmaily Dental & Orthodontics, P.C. Dentist Past Accepting new patients
Advanced Family Dental, P.C. Dentist Past Accepting new patients
Advanced Family Dental and Orthodontics, P.C. Dentist Past Accepting new patients

Organizations & group practices 12

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699873588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 THEODORE ST",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604351881",
            "telephone_number": "815-741-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 THEODORE ST",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604351881",
            "telephone_number": "815-741-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIS",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-016447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crest Hill, 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.