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KRYSTLE GRANDBERRY WIDEN DMD
NPI 1063942159
Dentist - General Practice in Oak Park, IL

Active since June 12, 2017
1113 CHICAGO AVE, OAK PARK, IL 60302(708) 383-0500 Get Directions Write a Review

NPPES record last updated: February 16, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 17, 2018, Jun 12, 2017 (2 updates tracked since 2017).

About Krystle Grandberry Widen Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRYSTLE GRANDBERRY WIDEN DMD (NPI 1063942159) is an individual general practice provider in Oak Park, Illinois, licensed in Illinois (019.033543) and active in the NPI registry since June 2017.

NPPES Registry Identity

NPI1063942159
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameKRYSTLE GRANDBERRY WIDENCredential: DMD
Location Address1113 CHICAGO AVEOak Park, IL 60302-1803
Mailing Address2307 W Melrose StChicago, IL 60618-6317
Phone(708) 383-0500
Sole ProprietorNo
Enumeration DateJune 12, 2017
Last NPPES UpdateFebruary 16, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 16, 2024
✔ NPI 1063942159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IL · 019.033543
Definition
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.
1113 CHICAGO AVE, Oak Park, IL 60302
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and more.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Dentist (General Practice)
1113 CHICAGO AVE
OAK PARK, IL 60302
Cook County (708) 383-0500
DR. RENE TANQUILUT DDS
Dentist
1113 CHICAGO AVE
OAK PARK, IL 60302
Cook County (708) 790-2169

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Krystle Widen's NPI number?

The NPI number for Krystle Widen is 1063942159. It was assigned to this individual provider in the NPPES registry on June 12, 2017.

Where is Krystle Widen located?

Krystle Widen practices at 1113 Chicago Ave, Oak Park, IL 60302. The listed phone number is (708) 383-0500.

What is Krystle Widen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Krystle Widen accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 4 other insurers list Krystle Widen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Krystle Widen was last updated on February 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.