College Square Dental
NPI 1760665442ActiveOrganization· Dentist, General Practice· Lisle, IL
Dentist, General Practice in Lisle, Illinois, registered in NPPES in December 2007. The authorized official on file is Deann Derrico, Business Administrator.
Overview
| NPI | 1760665442 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 17, 2007 |
| Last updated in NPPES | Apr 10, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 019-019814 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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