Victoria Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025723 Issued in IL

Legal business name

VICTORIA DENTAL

Practice address

16117 Weber Rd
Crest Hill, IL 60403-8742

Phone

(815) 836-3432

Fax

(815) 836-3517

NPI assigned

Sep 17, 2008

Organization subpart

Yes

Parent organization

VICTORIA DENTALAs reported in NPPES

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

Authorized official

Name

Dr. Victoria Muzykansky, DDSNPI 1922167741

Title

Owner

Phone

(630) 370-1312

Specialties & licenses 1

Addresses

Part of

Victoria Dental

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victoria Muzykansky, DDS

  • General Practice Dentistry
  • Des Plaines, IL
  • NPI 1922167741
  NPD (past) Authorized official

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1699924308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16117 WEBER RD",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604038742",
            "telephone_number": "815-836-3432",
            "fax_number": "815-836-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16117 WEBER RD",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604038742",
            "telephone_number": "815-836-3432",
            "fax_number": "815-836-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VICTORIA DENTAL",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "MUZYKANSKY",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-370-1312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Crest Hill, IL
• Providers in Crest Hill, 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 Sep 17, 2008; 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.