NPIMap

Organization Active NPI

Dominik Dubravec DDS MMSC PC

  • Periodontics
  • Frankfort, IL
National Provider Identifier
1992126304
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
019021633 Issued in IL
Legal business name
DOMINIK DUBRAVEC DDS MMSC PC
Practice address
20635 Abbey Woods CT N
Suite 203
Frankfort, IL 60423-3181
Phone
(815) 464-3001
Fax
(815) 464-3010
NPI assigned
Jan 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Dr. Dominik Dubravec, DDS MMSC
Title
President
Phone
(815) 464-3001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 019021633 IL Primary

Addresses

Primary practice location

20635 Abbey Woods CT N
Suite 203
Frankfort, IL 60423-3181

Mailing address

20635 Abbey Woods CT N
Suite 203
Frankfort, IL 60423-3181
Phone (815) 464-3001

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1992126304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20635 ABBEY WOODS CT N",
            "address_2": "SUITE 203",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233181",
            "telephone_number": "815-464-3001",
            "fax_number": "815-464-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20635 ABBEY WOODS CT N",
            "address_2": "SUITE 203",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233181",
            "telephone_number": "815-464-3001",
            "fax_number": "815-464-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINIK DUBRAVEC DDS MMSC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "DUBRAVEC",
        "authorized_official_first_name": "DOMINIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-464-3001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MMSC"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019021633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.