Individual provider Active NPI

Diane R. Talentowski, DDS

  • General Practice Dentistry
  • Western Springs, IL
National Provider Identifier
1962548172
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0190206003 Issued in IL
Practice address
518 Hillgrove Ave
Suite 100
Western Springs, IL 60558-1442
Phone
(708) 246-8887
Fax
(708) 246-6858
NPI assigned
Jan 29, 2007
Sex
Female
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 0190206003 IL Primary

Addresses

Primary practice location

518 Hillgrove Ave
Suite 100
Western Springs, IL 60558-1442

Mailing address

518 Hillgrove Ave
Western Springs, IL 60558-1442
Phone (708) 246-8887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Nov 12, 2014 through Nov 12, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0190206003ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962548172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 HILLGROVE AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581442",
            "telephone_number": "708-246-8887",
            "fax_number": "708-246-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 HILLGROVE AVE",
            "address_2": "SUITE 100",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581442",
            "telephone_number": "708-246-8887",
            "fax_number": "708-246-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALENTOWSKI",
        "first_name": "DIANE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "0190206003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Western Springs, IL

Sources for this page

Verify at the official NPI Registry.