Individual provider Active NPI

Stephanie Cravens, D.D.S.

  • General Practice Dentistry
  • Naperville, IL
National Provider Identifier
1790149631
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019025797 Issued in IL
Practice address
2776 Forgue Dr
Suite 106
Naperville, IL 60564-4175
Phone
(630) 305-0312
NPI assigned
Apr 6, 2016
Last updated
Apr 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019025797 IL Primary
General Practice Dentistry 1223G0001X 2901018309 MI

Addresses

Primary practice location

2776 Forgue Dr
Suite 106
Naperville, IL 60564-4175

Mailing address

2776 Forgue Dr
Suite 106
Naperville, IL 60564-4175
Phone (630) 305-0312

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
019025797ILMDGeneral Practice Dentistry
2901018309MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1790149631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 FORGUE DR",
            "address_2": "SUITE 106",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644175",
            "telephone_number": "630-305-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 FORGUE DR",
            "address_2": "SUITE 106",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644175",
            "telephone_number": "630-305-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVENS",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025797",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.