DR. GINA E BRUCK (NPI# 1619990264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619990264 |
| Entity Type | Individual |
| Full Name | DR. GINA E BRUCK |
| Credential | D.D.S. |
| Practice Address |
607 W Jefferson St Shorewood IL 60404-3700 |
| Practice Telephone | 8157255991 |
| Practice Fax Number | 8157251983 |
| Mailing Telephone | 8157255991 |
| Mailing Fax Number | 8157251983 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2016-07-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019025631 | IL | Dental Providers |
| Street Address |
607 W JEFFERSON ST |
| City | SHOREWOOD |
| State | IL |
| Zip Code | 60404-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477969251 | Britly Barton | Dentist | 607 W Jefferson St, Shorewood, IL 60404-3700 | 2014-07-01 |
| 1033317847 | Shorewood Family Dental Care LLP | Dentist | 607 W Jefferson St, Shorewood, IL 60404-3701 | 2007-07-03 |
| 1639249063 | Chris Zumstein | Dentist | 607 W Jefferson St, Shorewood, IL 60431-9701 | 2006-11-09 |
| 1568485191 | Robert Sean Funk | Dentist | 607 W Jefferson St, Shorewood, IL 60431-9701 | 2006-07-25 |
| 1932129723 | Henry Vicioso | Dentist | 607 W Jefferson St, Shorewood, IL 60431-9701 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669035242 | Mobile Dental Care of Delaware, Pa | Dentist | 18622 S. Rte 59 Unit A-1, Shorewood, IL 60404 | 2019-04-18 |
| 1326476755 | Christine Briski | Speech-Language Pathologist | 210 W Black Road, Shorewood, IL 60404 | 2013-10-22 |
| 1598000630 | Michael G Mcdowell | Nurse Practitioner | 1039 Brookforest Ave, Shorewood, IL 60404 | 2012-11-29 |
| 1699028910 | Patti-ann Ebert | Occupational Therapist | 850 Brook Forest Ave., Unit L, Shorewood, IL 60404 | 2012-10-24 |
| 1043567720 | Matthew Reiot Klebenow | Occupational Therapist | 852a Sharp Drive, Provena Physical Therapy & Industrial Rehab. Center, Shorewood, IL 60404 | 2012-08-13 |
| 1366728222 | Linda K Alonso | Pharmacist | 1160 W. Jefferson St., Shorewood, IL 60404 | 2011-10-24 |
| 1205110186 | Lanie R Moreno | Physical Therapist | 850 Brookforest Ave Unit L, Shorewood, IL 60404 | 2011-10-10 |
| 1932386810 | Advanced Family Dental of Shorewood, P.C. | Dentist | 150 N Brook Forest Drive, Shorewood, IL 60404 | 2008-01-23 |
| 1003025941 | Kerri Lanum | Specialist/Technologist | 850 Brookforest Ave. F, Shorewood, IL 60404 | 2007-05-21 |
| 1124246756 | Alexander Grabavoy | Dentist | 1007 W. Jefferson Street, Shorewood, IL 60404 | 2007-04-20 |
| Find all providers in zip 60404 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669035242 | Mobile Dental Care of Delaware, Pa | Dentist | 18622 S. Rte 59 Unit A-1, Shorewood, IL 60404 | 2019-04-18 |
| 1750670014 | Benjamin Singer Johnson | Dentist | 4027 N Bartlett Ave, Shorewood, WI 53211-1909 | 2011-04-06 |
| 1205145554 | Dental Sleep Center Richard A Craig Dds Ltd | Dentist | 220 Channahon St, Shorewood, IL 60404-9330 | 2010-10-05 |
| 1710216494 | Klara Fleysh | Dentist | 1714 E Capitol Dr, Shorewood, WI 53211-1910 | 2009-12-09 |
| 1194903591 | Brookforest Dental Group, P.C. | Dentist | 850 Brookforest Dr, Suite D, Shorewood, IL 60431-8513 | 2008-02-07 |
| 1528270972 | Katherine J. Kircher | Dentist | 1400 E Capitol Dr, Shorewood, WI 53211-1957 | 2007-05-05 |
| 1952440687 | Ami Arun Shah | Dentist | 968 Brook Forest Ave, Unit B1, Shorewood, IL 60431-8807 | 2007-02-06 |
| 1689738155 | Keith Alan Ziolkowski | Dentist | 3970 N Oakland Ave Ste 403, Shorewood, WI 53211-2265 | 2006-12-20 |
| 1700956125 | Faber Dental Arts | Dentist | 609 Rollingwood Dr, Shorewood, IL 60404-0665 | 2006-11-09 |
| 1629097662 | Edwin S Brookes | Dentist | 3970 N Oakland Ave Ste 602, Shorewood, WI 53211-2265 | 2006-07-19 |
| Find all providers in SHOREWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.