176 Dental Associates LTD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

176 DENTAL ASSOCIATES LTD

Practice address

176 S Bloomingdale Rd
Bloomingdale, IL 60108-1404

Phone

(630) 893-6200

Fax

(630) 893-0474

NPI assigned

Jan 18, 2007

Organization subpart

No

Name

Joseph MatustikNPI 1801057674

Title

Owner

Phone

(630) 893-6200

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Michael Matustik, D.D.S.

  • General Practice Dentistry
  • Bloomingdale, IL
  • NPI 1801057674

  General Practice

  NPD (past) Authorized official
• Dominic A Colletti, D.D.S.

  • General Practice Dentistry
  • Bloomingdale, IL
  • NPI 1215198098

  General Practice

  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992858674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 S BLOOMINGDALE RD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 S BLOOMINGDALE RD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081404",
            "telephone_number": "630-893-6200",
            "fax_number": "630-893-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "176 DENTAL ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATUSTIK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-893-6200"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bloomingdale, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.