NPIMap

Individual provider Active NPI

Matthew Scott Vanbeek, DDS

  • General Practice Dentistry
  • Lisle, IL
National Provider Identifier
1821448515
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019030687 Issued in IL
Practice address
6448 College Rd
Lisle, IL 60532-3290
Phone
(630) 983-8700
Fax
(630) 983-8512
NPI assigned
Jun 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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 019030687 IL Primary

Addresses

Primary practice location

6448 College Rd
Lisle, IL 60532-3290

Mailing address

6448 College Rd
Lisle, IL 60532-3290
Phone (630) 983-8700

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
019030687ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
College Square Dental General Practice Past Accepting new patients
James L Derrico DDS Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1821448515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6448 COLLEGE RD",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323290",
            "telephone_number": "630-983-8700",
            "fax_number": "630-983-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6448 COLLEGE RD",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323290",
            "telephone_number": "630-983-8700",
            "fax_number": "630-983-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBEEK",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.