NPIMap

Organization Active NPI

Bryan a Weyneth DDS PC

  • Dentist
  • Naperville, IL
National Provider Identifier
1972146470
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BRYAN A WEYNETH DDS PC
Practice address
1100 Sherman Ave Ste 1031100
Naperville, IL 60563-8608
Phone
(630) 369-5225
Fax
(630) 369-7416
NPI assigned
Oct 28, 2019
Last updated
Oct 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Authorized official

Name
Dorothy Hernandez, CREDENTIALING AGENTNPI 1205330511
Title
Credentialing Agent Contract Labor
Phone
(928) 779-4404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1100 Sherman Ave Ste 1031100
Naperville, IL 60563-8608

Mailing address

1100 Sherman Ave Ste 1031100
Naperville, IL 60563-8608
Phone (630) 369-5225

Other names 1

  • BRYAN A WEYNETH DDS PC Former legal business name

National Provider Directory

National Provider Directory

Locations

1100 Sherman Ave
Ste 1031100
Naperville, IL 60563
Phone (630) 369-5225

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1972146470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SHERMAN AVE STE 1031100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638608",
            "telephone_number": "630-369-5225",
            "fax_number": "630-369-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SHERMAN AVE STE 1031100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638608",
            "telephone_number": "630-369-5225",
            "fax_number": "630-369-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN A WEYNETH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_title_or_position": "CREDENTIALING AGENT CONTRACT LABOR",
        "authorized_official_telephone_number": "928-779-4404",
        "authorized_official_credential": "CREDENTIALING AGENT"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRYAN A WEYNETH DDS PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.