PHILCO DENTAL GROUP LLC - SPRINGFIELD (NPI# 1003328675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003328675 |
| Entity Type | Organization |
| Organization Name | PHILCO DENTAL GROUP LLC - SPRINGFIELD |
| Practice Address |
2701 N Dirksen Pkwy Springfield IL 62702-1407 |
| Mailing Address |
Po Box 3189 Syracuse NY 13220-3189 |
| Practice Telephone | 2174921400 |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-11-03 |
| Authorized Official Name | AARON PHILLIPS (OWNER) |
| Authorized Official Telephone | 2174921400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
2701 N DIRKSEN PKWY |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528449873 | Min Soo Kim | Dentist | 2701 N Dirksen Pkwy, Springfield, IL 62702-1407 | 2015-06-12 |
| 1871190884 | Jorge Enrique Mosquera Castrillon | Dentist | 2701 N Dirksen Pkwy, Springfield, IL 62702-1407 | 2020-10-02 |
| 1720591837 | Ali Jarrar | Dentist | 2701 N Dirksen Pkwy, Springfield, IL 62702-1407 | 2017-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969034 | Dental Professionals of Virginia, P.C. | Dentist | 7015 Old Keene Mill Rd Ste 101, Springfield, VA 22150-2805 | 2020-07-09 |
| 1336790609 | Mahmoud Al Homsi | Dentist | 41 Taylor St. 4th Fl, Springfield, MA 01103 | 2019-09-26 |
| 1730734369 | Taylor Eiford | Dentist | 200 N Fountain Ave, Springfield, OH 45504-2535 | 2019-08-09 |
| 1376198366 | Cynthia Park | Dentist | 8328 Traford Ln Ste B, Springfield, VA 22152-1667 | 2019-08-06 |
| 1588225155 | Mckenzie Dental Center | Dentist | 110 S. 59th St, Springfield, OR 97478 | 2019-06-25 |
| 1376100651 | Haiping Sun | Dentist | 1705 E Primrose St, Springfield, MO 65804-4292 | 2019-05-22 |
| 1740845619 | Patrick Greitzer | Dentist | 251 Hampton Pl, Springfield, OH 45503-2613 | 2019-05-07 |
| 1033674106 | Tags Inc | Dentist | 1557 E Primrose St Ste 116, Springfield, MO 65804-7916 | 2019-02-04 |
| 1366916272 | Baines Dental, LLC | Dentist | 1112 Rickard Rd Ste A, Springfield, IL 62704-1021 | 2019-01-14 |
| 1225502362 | Liebentritt Family Dentistry | Dentist | 191 Main St., Springfield, NE 68059 | 2019-01-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on PHILCO DENTAL GROUP LLC - SPRINGFIELD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.