Active NPI
Kristen Marie Joyce, D.D.S.
- Dentist
- Lake Zurich, IL
National Provider Identifier
1700037785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019027664
- 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, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160706001549 | WI | Order and Referring Only - Dentist | 1153613419 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019027664 | IL | MD | Dentist |
| 6480 | WI | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.