Douglas Pennino, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021619 Issued in IL

Practice address

101 Lions Dr
Suite 100
Barrington, IL 60010-3181

Phone

(847) 381-6222

Fax

(847) 381-2916

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1841364049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LIONS DR",
            "address_2": "SUITE 100",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600103181",
            "telephone_number": "847-381-6222",
            "fax_number": "847-381-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LIONS DR",
            "address_2": "SUITE 100",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600103181",
            "telephone_number": "847-381-6222",
            "fax_number": "847-381-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINO",
        "first_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Pawley Pearson, PTA
• Pediatric Care P.C.
• Kenneth Read Peirce, MD
• Chase Douglas Pennino, DDS
• Connor Andrew Pennino, D.D.S.
• Andrea B Perez, MA, ATR, LCPC
• Stacy Lynn Perkins Smith, MA, LCPC
• Kathryn Ann Perkins, AU.D.
• Jenna Perrine, LPC
• Daniel J Pesavento, M.D.

• General Practice Dentistry in Barrington, IL
• Providers in Barrington, 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 Jan 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.