Individual provider Active NPI

Dennis James McDowell, D.D.S.

  • Dentist
  • Crystal Lake, IL
National Provider Identifier
1720150097
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
690 N Il Route 31
Suite E
Crystal Lake, IL 60012-3790
Phone
(815) 455-6120
Fax
(815) 455-7024
NPI assigned
Nov 14, 2006
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 IL Primary

Addresses

Primary practice location

690 N Il Route 31
Suite E
Crystal Lake, IL 60012-3790

Mailing address

690 N Il Route 31
Suite E
Crystal Lake, IL 60012-3790
Phone (815) 455-6120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150520002371 IL Order and Referring Only - DentistPractitioner - Dentist 4082934799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019017240ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720150097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 N IL ROUTE 31",
            "address_2": "SUITE E",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123790",
            "telephone_number": "815-455-6120",
            "fax_number": "815-455-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 N IL ROUTE 31",
            "address_2": "SUITE E",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123790",
            "telephone_number": "815-455-6120",
            "fax_number": "815-455-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "DENNIS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.