Rebecca J Weightman, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

021.002665 Issued in IL

Practice address

6901 West Stanley Ave
Berwyn, IL 60402

Phone

(708) 749-4080

NPI assigned

Feb 19, 2013

Last updated

Dec 8, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1841530433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 WEST STANLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402",
            "telephone_number": "708-749-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 WEST STANLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402",
            "telephone_number": "708-749-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIGHTMAN",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-19",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "01929292",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021.002665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.