Jay A Wygodny, DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-019212 Issued in IL

Practice address

2592 E Grand Ave Ste 102
Lindenhurst, IL 60046-5915

Phone

(847) 265-4420

Fax

(847) 265-4429

NPI assigned

Jun 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Jay a Wygodny DMD, PC

  • Dental Clinic/Center
  • Lindenhurst, IL
  • NPI 1841626793
  NPD Authorized official
• Jay a Wygodny DMD PC

  • Durable Medical Equipment & Medical Supplies
  • Lindenhurst, IL
  • NPI 1528691508
  NPD Authorized official

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1720282999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 E GRAND AVE STE 102",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600465915",
            "telephone_number": "847-265-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 E GRAND AVE STE 102",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600465915",
            "telephone_number": "847-265-4420",
            "fax_number": "847-265-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYGODNY",
        "first_name": "JAY",
        "middle_name": "A",
        "credential": "DMD PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-019212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelyn Alice Wilkinson
• Adam Giles Witt, DPT, PT, CSCS
• Stewart M Wurtz, LMT
• Wyant Pediatric Therapy Services, Inc.
• Julie K Wyant, OTR
• Christine Ann Wyszomirski, P.A.-C

• General Practice Dentistry in Lindenhurst, IL
• Providers in Lindenhurst, 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 Apr 5, 2021; 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.

Verify at the official NPI Registry.