WEST SIDE FAMILY DENTISTRY, LTD (NPI# 1245617570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245617570 |
| Entity Type | Organization |
| Organization Name | WEST SIDE FAMILY DENTISTRY, LTD |
| Practice Address |
709 Plaza Dr Mendota IL 61342-2457 |
| Practice Telephone | 8155397004 |
| Practice Fax Number | 8155397060 |
| Mailing Telephone | 8155397004 |
| Mailing Fax Number | 8155397060 |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2015-05-06 |
| Authorized Official Name | DR. KERI LYNN SUNDBERG (DENTIST/PRESIDENT) |
| Authorized Official Telephone | 8155397004 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019-025531 | IL | Dental Providers |
| Street Address |
709 PLAZA DR |
| City | MENDOTA |
| State | IL |
| Zip Code | 61342-2457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568536845 | Keri Sundberg | Dentist | 709 Plaza Drive, Mendota, IL 61342 | 2006-11-20 |
| 1114022589 | Goslin Drug Store Inc | Pharmacy | 1212 13th Ave, Mendota, IL 61342 | 2006-09-13 |
| 1467402412 | Neungja Chung | Acupuncturist | Mendota Community Hospital, 1315 Memorial Drive, Mendota, IL 61342 | 2006-05-11 |
| 1487622205 | Kelly R. Minihane | Physician Assistant | 1404 Washington Street, Mendota, IL 61342 | 2006-03-08 |
| 1134193022 | Donald Wilbert Piller | Chiropractor | 1312 Lakewood Dr, Mendota, IL 61342 | 2006-02-15 |
| 1770975377 | National Pain Clinic, LLC | Anesthesiology | 1401 E 12th St, Mendota, IL 61342 | 2015-02-19 |
| 1073869475 | Katherine Rose Riva-foster | Anesthesiology | 1401 E 12th St, Mendota, IL 61342 | 2012-08-03 |
| 1386789220 | Juli Renee Barrett Leifheit | Chiropractor | 901 Main St, Ste A, Mendota, IL 61342 | 2007-02-20 |
| 1205383197 | Mendota Community Hospital | Clinic/Center | 1401 Washington Street, Mendota, IL 61342-0001 | 2016-09-08 |
| 1780699447 | Linnea L Person | Chiropractor | 1301 14th Ave, Mendota, IL 61342-1001 | 2006-07-30 |
| Find all providers in zip 61342 | ||||
| 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 |
|---|---|---|---|---|
| 1912465626 | Gayathri Parameswaran Iyer | Dentist | United Health Centers, 121 Barboza St, Mendota, CA 93640 | 2019-03-12 |
| 1063534451 | Robert John Krenz | Dentist | 704 Indiana Ave, Mendota, IL 61342-1617 | 2007-04-04 |
| 1568536845 | Keri Sundberg | Dentist | 709 Plaza Drive, Mendota, IL 61342 | 2006-11-20 |
| 1659458602 | Peter Doran | Dentist | 1318 Meriden St, Mendota, IL 61342-1030 | 2006-11-01 |
| 1942323787 | Jon C Krenz | Dentist | 704 Indiana Ave, Mendota, IL 61342-1617 | 2007-04-09 |
| 1962524363 | Krenz Dental Corp. Ltd | Dentist | 704 Indiana Ave, Mendota, IL 61342-1617 | 2007-04-04 |
| 1063546893 | Bum Kim | Dentist | 121 Barboza St, Mendota, CA 93640-1901 | 2007-03-15 |
| 1356489801 | Ernesto Antonio Villalobos | Dentist | 1318 Meriden St, Mendota, IL 61342-1030 | 2007-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425230 | Sundeep Franklin Dmd & Daiana Capota Dmd Pllc | Dentist | 320 N Mclean Blvd Ste B, Elgin, IL 60123-3220 | 2020-10-20 |
| 1801403555 | Stephanie Elizabeth Miller | Dentist | 2220 Sisters Ave, Naperville, IL 60564-4394 | 2020-09-27 |
| 1417564121 | Gursimran Reen, Dmd LLC | Dentist | 29 S Webster St Ste 108, Naperville, IL 60540-5353 | 2020-09-26 |
| 1285240531 | Summit Dental Center LLC | Dentist | 7710 W 62nd Pl, Summit, IL 60501-1702 | 2020-09-22 |
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1932713583 | Kevin G Reardon | Dentist | 479 S Spring Rd, Elmhurst, IL 60126-3857 | 2020-09-01 |
| 1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
| 1548870884 | Daniel Patrick Jurgens | Dentist | 2 N Country Club Rd Ste 2, Decatur, IL 62521-4174 | 2020-08-02 |
| 1184233934 | Shawna Jade Dudovitz | Dentist | 309 Tamarack Ln, Shiloh, IL 62269-2993 | 2020-07-28 |
| 1417565748 | Robert Hails | Dentist | 3540 N Belt W Ste B, Belleville, IL 62226-5975 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
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| 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.