Bassel Dulli, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

021-002106 Issued in IL

Practice address

1890 Silver Cross Blvd.
Suite 305
New Lenox, IL 60451

Phone

(630) 418-0476

Fax

(815) 717-8774

NPI assigned

May 27, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1750338877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "address_2": "SUITE 305",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519524",
            "telephone_number": "630-418-0476",
            "fax_number": "815-717-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD.",
            "address_2": "SUITE 305",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "630-418-0476",
            "fax_number": "815-717-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULLI",
        "first_name": "BASSEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021-002106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Roger Donley, MS, ATC
• Joseph Alan Dougherty, DMD
• Raymie Doyle, PTA
• Dr. Robert E. Puls, P.C.
• Samantha Joy Dubina
• Dupage Medical Group, LTD. (DuPage Medical Group)
• Trisha Durham, RN, FNP-C
• DW Enterprises (Hickory Creek Counseling)
• DW Enterprises LLC (Hickory Creek Counseling)
• Carey Dwyer, LSW

• Pediatric Dentistry in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.