Individual provider Active NPI

Kristen Marie Joyce, D.D.S.

  • Dentist
  • Lake Zurich, IL
National Provider Identifier
1700037785
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027664 Issued in IL
Practice address
775 W Main St
Lake Zurich, IL 60047-2348
Phone
(847) 540-6597
Fax
(847) 540-6598
NPI assigned
Oct 8, 2008
Last updated
Oct 8, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019027664 IL Primary

Addresses

Primary practice location

775 W Main St
Lake Zurich, IL 60047-2348

Mailing address

775 W. Main Street
Lake Zurich, IL 60047
Phone (847) 540-6597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20160706001549 WI Order and Referring Only - DentistPractitioner - Dentist 1153613419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019027664ILMDDentist
6480WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Young Song Corp. Past Accepting new patients

Organizations & group practices 1

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1700037785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 W. MAIN STREET",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-540-6597",
            "fax_number": "847-540-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 W MAIN ST",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600472348",
            "telephone_number": "847-540-6597",
            "fax_number": "847-540-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOYCE",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Zurich, IL

Sources for this page

Verify at the official NPI Registry.