Individual provider Active NPI

Diana Dziuba-Wielga, DDS

  • General Practice Dentistry
  • Bensenville, IL
National Provider Identifier
1770790180
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19-021800 Issued in IL
Practice address
18 N York Rd
Bensenville, IL 60106-2141
Phone
(630) 797-8644
Fax
(630) 616-8100
NPI assigned
May 16, 2007
Last updated
Feb 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2009

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 19-021800 IL Primary

Addresses

Primary practice location

18 N York Rd
Bensenville, IL 60106-2141

Mailing address

18 N York Rd
Bensenville, IL 60106-2141
Phone (630) 797-8644

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
I20160406002365 IL Order and Referring Only - DentistPractitioner - Dentist 3971801952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19-021800ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry for Today, P.C. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233878400000",
    "number": "1770790180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 N YORK RD",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062141",
            "telephone_number": "630-797-8644",
            "fax_number": "630-616-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 N YORK RD",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062141",
            "telephone_number": "630-797-8644",
            "fax_number": "630-616-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIUBA-WIELGA",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2009-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19-021800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensenville, IL

Sources for this page

Verify at the official NPI Registry.