Individual provider Active NPI

David Vincent Safranski, DMD

  • Dentist
  • Spring Valley, IL
National Provider Identifier
1962605253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
229 W Dakota St
Spring Valley, IL 61362-1905
Phone
(815) 663-8131
NPI assigned
Jun 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X IL Primary

Addresses

Primary practice location

229 W Dakota St
Spring Valley, IL 61362-1905

Mailing address

229 W Dakota St
Spring Valley, IL 61362-1905
Phone (815) 663-8131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160309001496 IL Order and Referring Only - DentistPractitioner - Dentist 6002112596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-019201ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962605253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W DAKOTA ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621905",
            "telephone_number": "815-663-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W DAKOTA ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621905",
            "telephone_number": "815-663-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFRANSKI",
        "first_name": "DAVID",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, IL

Sources for this page

Verify at the official NPI Registry.