Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063942159 Individual Practitioner Female Practitioner

Dr. Krystle Grandberry Widen , DMD

Dentist - General Practice • Oak Park, IL

Professional Overview & Biography Verified Profile Summary

Dr. Krystle Widen, DMD is a registered healthcare professional specializing in Dentist - General Practice in Oak Park, IL. Practice services are available at 1113 CHICAGO AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1113 Chicago Ave

Oak Park, IL 603021803

Telephone 7083830500
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Oak Park, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 29.0 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
54 Specialists

Practicing in Oak Park, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-02-16
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019.033543

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Pamela Reynolds , DDS

Dentist - General Practice

NPI 1699974279

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location February 16, 2024

Registered at 1113 CHICAGO AVE, OAK PARK, IL 603021803 (Tel: 7083830500)

📍
Updated Business Mailing Address February 16, 2024

Registered at 2307 W MELROSE ST, CHICAGO, IL 606186317

👤
Provider Name / Credentials Updated February 16, 2024

Recorded as KRYSTLE WIDEN, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2024

Dentist (License #019.033543 in IL)

NPI Profile Active June 12, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 12, 2017

Registered at 22 ALPINE LN, CHELMSFORD, MA 018242703 (Tel: 9782567581)

📍
Updated Business Mailing Address June 12, 2017

Registered at 445 ARTISAN WAY APT 509, SOMERVILLE, MA 021451254

👤
Provider Name / Credentials Updated June 12, 2017

Recorded as KRYSTLE GRANDBERRY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 12, 2017

Dentist (License #DN1857603 in MA)

🟢
Initial NPI Registration & Enumeration June 12, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063942159
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 12, 2017
Last Update: February 16, 2024
Sole Proprietor: No

Mailing Address

2307 W Melrose St

Chicago, IL 606186317

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.