Amy Marie Dustoor, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019029369 Issued in IL

Practice address

1921 W North Ave
Chicago, IL 60622-1351

Phone

(773) 276-0335

NPI assigned

Jul 26, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Amy Marie Krukemeyer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Lincoln Square Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1417559675
  NPD
• Wicker Park Orthodontia, LTD.

  dba Wicker Park Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1609016351
  NPD (past)

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

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1891137170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221351",
            "telephone_number": "773-276-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSTOOR",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019029369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "KRUKEMEYER",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DDS, MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Mary Dusak, P.A.-C
• Nilufar Duschanova, MD
• Scott P Dusenbery
• Eddie Anthony Dusik Vargas, PT, DPT
• Maria Dussias, PT
• Mateusz Dusza, MD
• Annalese Rayen Dutch, LCSW
• Jose Dutra, MD
• Gabriella Dutson, DO
• Sharon L Duval, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.