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FREDERICK GUSTAVE, D.D.S., PC
NPI 1477720985
Clinic/Center - Oral and Maxillofacial Surgery in Carbondale, IL

Active since May 14, 2008
1111 E WALNUT ST, SUITE B, CARBONDALE, IL 62901(618) 529-2571(618) 529-2572 Get Directions Write a Review

NPPES record last updated: May 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Frederick Gustave, D.d.s., Pc NPPES

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

FREDERICK GUSTAVE, D.D.S., PC (NPI 1477720985) is a healthcare organization registered as an oral and maxillofacial surgery in Carbondale, Illinois and active in the NPI registry since May 2008. The organization lists Frederick Gustave, Owner/oral Surgeon, as its authorized official.

NPPES Registry Identity

NPI1477720985
Entity TypeOrganization
Primary Taxonomy261QS0112X
Legal Business NameFREDERICK GUSTAVE, D.D.S., PC
Location Address1111 E WALNUT ST, SUITE BCarbondale, IL 62901-5000
Mailing Address1111 E Walnut St, Suite BCarbondale, IL 62901-5000 · (618) 529-2571 · Fax (618) 529-2572
Phone(618) 529-2571
Fax(618) 529-2572
Organization SubpartNo
Authorized OfficialFrederick GustaveOwner/oral Surgeon · (618) 529-2571
Enumeration DateMay 14, 2008
✔ NPI 1477720985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Oral and Maxillofacial SurgeryAmbulatory Health Care Facilities
Taxonomy Code261QS0112X
License✔ Licensed in IL · 019016600
Definition
An oral and maxillofacial surgery clinic or center 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.
1111 E WALNUT ST, Carbondale, IL 62901
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Other Identifiers 1

Medicare PIN654820IL

Other Providers at the Same Location NPPES 3

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

ADEDOYIN IDAYAT MALIK DDS
Dentist
1111 E WALNUT ST
CARBONDALE, IL 62901
Jackson County (618) 529-2471
DR. MICHAEL ROBERT DURR D.M.D.
Dentist (General Practice)
1111 E WALNUT ST
CARBONDALE, IL 62901
Jackson County (618) 529-2471
JULIE MARIE WACHTEL
Specialist
1111 E WALNUT ST
CARBONDALE, IL 62901
Jackson County (618) 529-2471

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 Frederick Gustave, D.D.S., PC's NPI number?

The NPI number for Frederick Gustave, D.D.S., PC is 1477720985. It was assigned to this organization in the NPPES registry on May 14, 2008.

Where is Frederick Gustave, D.D.S., PC located?

Frederick Gustave, D.D.S., PC is located at 1111 E Walnut St Suite B, Carbondale, IL 62901. The listed phone number is (618) 529-2571.

What is Frederick Gustave, D.D.S., PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Oral and Maxillofacial Surgery, with taxonomy code 261QS0112X.

When was this NPI record last updated?

The NPPES record for Frederick Gustave, D.D.S., PC was last updated on May 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.