Individual provider Active NPI

Dennis Costis, DDS

  • Dentist
  • Arlington Heights, IL
National Provider Identifier
1962659797
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019019202 Issued in IL
Practice address
1792 S Arlington Heights Rd
Arlington Heights, IL 60005-3727
Phone
(847) 806-6100
NPI assigned
Aug 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019019202 IL Primary

Addresses

Primary practice location

1792 S Arlington Heights Rd
Arlington Heights, IL 60005-3727

Mailing address

1792 S Arlington Heights Rd
Arlington Heights, IL 60005-3727
Phone (847) 806-6100

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
019019202ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1962659797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 S ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053727",
            "telephone_number": "847-806-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 S ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053727",
            "telephone_number": "847-806-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTIS",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019019202",
            "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 Aug 22, 2008; 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.