Active NPI
Anthony J Bennett, D.D.S.
- Oral and Maxillofacial Surgery (Dentist)
- Elgin, IL
National Provider Identifier
1770575292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- Practice address
- 1425 N McLean Blvd
Suite 200
Elgin, IL 60123-5723 - Phone
- (847) 697-6868
- Fax
- (847) 697-8355
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | IL | Primary |
Addresses
Primary practice location
1425 N McLean Blvd
Suite 200
Elgin, IL 60123-5723
Mailing address
1425 N McLean Blvd
Suite 200
Elgin, IL 60123-5723
Phone (847) 697-6868
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021-000966 | IL | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Odin Waite, P.C. | Oral and Maxillofacial Surgery | 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 and National Provider Directory roles.
-
- Oral and Maxillofacial Surgery (Dentist)
- Elgin, IL
- NPI 1952803504
Oral and Maxillofacial Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1770575292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 N MCLEAN BLVD",
"address_2": "SUITE 200",
"city": "ELGIN",
"state": "IL",
"postal_code": "601235723",
"telephone_number": "847-697-6868",
"fax_number": "847-697-8355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 N MCLEAN BLVD",
"address_2": "SUITE 200",
"city": "ELGIN",
"state": "IL",
"postal_code": "601235723",
"telephone_number": "847-697-6868",
"fax_number": "847-697-8355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "ANTHONY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.