Wibicki Family Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021866 Issued in IL

Legal business name

WIBICKI FAMILY DENTAL PC

Practice address

4 Cedar Ridge Drive
4F
Lake in the Hills, IL 60156

Phone

(847) 458-4758

NPI assigned

May 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kevin J Wibicki, D.D.S.

Title

President

Phone

(847) 458-4758

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1811216146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CEDAR RIDGE DRIVE",
            "address_2": "4F",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "60156",
            "telephone_number": "847-458-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CEDAR RIDGE DRIVE",
            "address_2": "4F",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "60156",
            "telephone_number": "847-458-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIBICKI FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "WIBICKI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-458-4758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Webb
• Jessica Weger
• Emma Weissler
• Kaylee Wells
• Margaret Westerkamp
• Kevin J Wibicki, D.D.S.
• Nancy G Wibicki, D.D.S.
• Carolina Wickman
• Lauren Willard
• Kiersten Williams

• General Practice Dentistry in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.