Robert E Traul Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019014422 Issued in IL

Practice address

991 Galena Square Dr
Galena, IL 61036-1355

Phone

(815) 776-9100

Fax

(815) 776-7776

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982734257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SUGARCREEK TRL",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610369351",
            "telephone_number": "815-777-3338",
            "fax_number": "815-777-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 GALENA SQUARE DR",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610361355",
            "telephone_number": "815-776-9100",
            "fax_number": "815-776-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUL",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019014422",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "11385",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179900",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Galena, IL
• Providers in Galena, 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 Jul 8, 2007; 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.