Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

DR. LUKE WANDZURA DMD
NPI 1366368177
Dentist - Oral and Maxillofacial Surgery in Maywood, IL

Q: What is Luke Wandzura's NPI number?

The NPI number for Luke Wandzura is 1366368177. It was assigned to this individual provider in the NPPES registry on June 25, 2026.

Q: What is Luke Wandzura's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Luke Wandzura was last updated on June 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.

Active since June 25, 2026PECOS Enrolled

2160 S 1ST AVE, MAYWOOD, IL 60153(888) 584-7888 Get Directions Write a Review

NPPES record added: June 26, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Dr. Luke Wandzura Dmd NPPES

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

DR. LUKE WANDZURA DMD (NPI 1366368177) is an individual oral and maxillofacial surgery provider in Maywood, Illinois, licensed in Illinois (018.012567) and active in the NPI registry since June 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366368177

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. LUKE WANDZURACredential: DMD

Location Address2160 S 1ST AVEMaywood, IL 60153-3328

Mailing Address2160 S 1st AveMaywood, IL 60153-3328 · (888) 584-7888

Phone(888) 584-7888

Sole ProprietorYes

Enumeration DateJune 25, 2026

Last NPPES UpdateJune 26, 2026

NPPES CertifiedJune 26, 2026

✔ NPI 1366368177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in IL · 018.012567

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

2160 S 1ST AVE, Maywood, IL 60153

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Luke Wandzura Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60153 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

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