Individual provider Active NPI

Dennis Navarro Dolleton, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Rockford, IL
National Provider Identifier
1922088962
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036088531 Issued in IL
Practice address
616 Regents CT
Rockford, IL 61107-5064
Phone
(815) 397-9290
NPI assigned
Jan 17, 2006
Last updated
Jun 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036088531 IL Primary

Addresses

Primary practice location

616 Regents CT
Rockford, IL 61107-5064

Mailing address

616 Regents CT
Rockford, IL 61107-5064
Phone (815) 397-9290

Other identifiers 1

IdentifierTypeStateIssuer
036088531MedicaidIL

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Illinois PLLC Past Accepting new patients
Rock Valley Pathologist Anatomic Pathology & Clinical Pathology Past Accepting new patients
CGH Medical Center Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1922088962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 REGENTS CT",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075064",
            "telephone_number": "815-397-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 REGENTS CT",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075064",
            "telephone_number": "815-397-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLLETON",
        "first_name": "DENNIS",
        "middle_name": "NAVARRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036088531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088531",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.