John Jacob Kussmaul Jr., D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

12007811A Issued in IN

Practice address

934 Richard Rd
Dyer, IN 46311-1936

Phone

(219) 865-9790

Fax

(219) 865-9792

NPI assigned

Mar 19, 2007

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)

Enrolled

State licenses

Practice roles

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.

• Illiana Endodontics, P.C.

  • Endodontics
  • Dyer, IN
  • NPI 1912070228
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1811011158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 RICHARD RD",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111936",
            "telephone_number": "219-865-9790",
            "fax_number": "219-865-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 RICHARD RD",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111936",
            "telephone_number": "219-865-9790",
            "fax_number": "219-865-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSSMAUL",
        "first_name": "JOHN",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12007811A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Krilich, FNP
• Zachary Krueger, PA
• Marisa Krupa, PHARMD
• Melissa Krzus
• Amit Kumar, M.D.
• Stanley J Ladowicz, LCSW
• David B Lemke, MD
• Fred Anthony Lepore Jr.
• Joan Levesque, LCAC
• Harvey Joseph Levin, MD

• Endodontics in Dyer, IN
• Providers in Dyer, IN by specialty
• Endodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; 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.