Steven David Wasowicz, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-023137 Issued in IL

Practice address

7630 W 111TH St
Palos Hills, IL 60465-2302

Phone

(708) 974-1319

Fax

(708) 974-4463

NPI assigned

May 8, 2007

Last updated

Dec 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kendall Family Dental

  dba Worth Palos Dentistry

  • General Practice Dentistry
  • Palos Hills, IL
  • NPI 1699036624
  NPD (past) Authorized official
• Worth Palos Dentistry

  • General Practice Dentistry
  • Palos Hills, IL
  • NPI 1588839849
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1962615393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7630 W 111TH ST",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604652302",
            "telephone_number": "708-974-1319",
            "fax_number": "708-974-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 W 111TH ST",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604652302",
            "telephone_number": "708-974-1319",
            "fax_number": "708-974-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASOWICZ",
        "first_name": "STEVEN",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-023137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sherry L Wille, OTR/L

• General Practice Dentistry in Palos Hills, IL
• Providers in Palos Hills, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.