Individual provider Active NPI

Dean Nichols, DDS

  • General Practice Dentistry
  • Arlington Heights, IL
National Provider Identifier
1942372818
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
121 S Wilke Rd
#120
Arlington Heights, IL 60005-1533
Phone
(847) 392-2141
Fax
(847) 392-7668
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

121 S Wilke Rd
#120
Arlington Heights, IL 60005-1533

Mailing address

121 S Wilke Rd
#120
Arlington Heights, IL 60005-1533
Phone (847) 392-2141

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019-020077ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Seredynski, DMD, PC PastSince Nov 21, 2021 Accepting new patients
Jeffrey Seredynski, DMD, PC PastSince Oct 24, 2021 Accepting new patients

Organizations & group practices 2

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942372818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD",
            "address_2": "#120",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051533",
            "telephone_number": "847-392-2141",
            "fax_number": "847-392-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD",
            "address_2": "#120",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051533",
            "telephone_number": "847-392-2141",
            "fax_number": "847-392-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.