NPIMap

Organization Active NPI

Michael D. Fedyna DDS, LTD.

  • Dentist
  • South Barrington, IL
National Provider Identifier
1710004510
Registry record updated Aug 13, 2007
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.020146 Issued in IL
Legal business name
MICHAEL D. FEDYNA DDS, LTD.
Practice address
8 Executive CT
Suite 2
South Barrington, IL 60010-9531
Phone
(847) 382-0700
Fax
(847) 382-0707
NPI assigned
Mar 25, 2007
Last updated
Aug 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Authorized official

Name
Dr. Michael D. Fedyna, DDS
Title
President
Phone
(847) 382-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.020146 IL Primary

Addresses

Primary practice location

8 Executive CT
Suite 2
South Barrington, IL 60010-9531

Mailing address

8 Executive CT
Suite 2
South Barrington, IL 60010-9531
Phone (847) 382-0700

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1710004510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 EXECUTIVE CT",
            "address_2": "SUITE 2",
            "city": "SOUTH BARRINGTON",
            "state": "IL",
            "postal_code": "600109531",
            "telephone_number": "847-382-0700",
            "fax_number": "847-382-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 EXECUTIVE CT",
            "address_2": "SUITE 2",
            "city": "SOUTH BARRINGTON",
            "state": "IL",
            "postal_code": "600109531",
            "telephone_number": "847-382-0700",
            "fax_number": "847-382-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D. FEDYNA DDS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-08-13",
        "status": "A",
        "authorized_official_last_name": "FEDYNA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-382-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.020146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Barrington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.