Goduco Family Dentistry, LTD.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GODUCO FAMILY DENTISTRY, LTD.

Practice address

281 Evergreen Dr
Vernon Hills, IL 60061-2905

Phone

(847) 816-0463

Fax

(847) 816-0468

NPI assigned

Aug 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Philip V Goduco, DDS, MAGDNPI 1225107642

Title

Dental Physician

Phone

(847) 816-0463

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip Villejo Goduco, DDS

  • General Practice Dentistry
  • Vernon Hills, IL
  • NPI 1225107642
  NPD Authorized official

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1881826279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 EVERGREEN DR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600612905",
            "telephone_number": "847-816-0463",
            "fax_number": "847-816-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 EVERGREEN DR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600612905",
            "telephone_number": "847-816-0463",
            "fax_number": "847-816-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GODUCO FAMILY DENTISTRY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "GODUCO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DENTAL PHYSICIAN",
        "authorized_official_telephone_number": "847-816-0463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MAGD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Maria Giorgetti, M.D.
• Rosemary S Giovannone, PH.D.
• Gita Physical Therapy PLLC
• Kari Lynn Glenn-Fitzgerald, MS
• Troy Lewis Glickstern, LPC
• Philip Villejo Goduco, DDS
• Leslie Ann Golde, LCSW
• Michelle Lynn Goldstein
• Vianka Gonzalez
• Lisa M Goodson

• Durable Medical Equipment & Medical Supplies in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.