Individual provider Active NPI

Robert B. Daszkiewicz, D.D.S.

  • General Practice Dentistry
  • Oswego, IL
National Provider Identifier
1770624728
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019020355 Issued in IL
Practice address
107 S Main St
Oswego, IL 60543-8593
Phone
(630) 554-2220
Fax
(630) 554-2548
NPI assigned
Feb 12, 2007
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
General Practice Dentistry 1223G0001X 019020355 IL Primary

Addresses

Primary practice location

107 S Main St
Oswego, IL 60543-8593

Mailing address

107 S Main St
PO Box 1043
Oswego, IL 60543-8593
Phone (630) 554-2220

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019020355ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770624728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S MAIN ST",
            "address_2": "PO BOX 1043",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438593",
            "telephone_number": "630-554-2220",
            "fax_number": "630-554-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S MAIN ST",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438593",
            "telephone_number": "630-554-2220",
            "fax_number": "630-554-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASZKIEWICZ",
        "first_name": "ROBERT",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.