DENTAL PROFESSIONALS OF ILLINOIS, P.C. (NPI# 1255884623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255884623 |
| Entity Type | Organization |
| Organization Name | DENTAL PROFESSIONALS OF ILLINOIS, P.C. |
| Other Organization Name | DENTAL CARE AT PRAIRIE CROSSING |
| Practice Address |
2740 Prairie Crossing Drive Springfield IL 62711 |
| Practice Telephone | 2179530891 |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-09-21 |
| Authorized Official Name | KENDRA WALKER (CREDENTIALING TEAM LEAD) |
| Authorized Official Telephone | 2175408312 |
| Is Organization Subpart | Y |
| Parent Organization Name | DENTAL PROFESSIONALS OF ILLINOIS, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Dental Care at Prairie Crossing | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669092177 | Dental Professionals of Illinois, P.C. | Dentist | 3419 Orchard Rd, Oswego, IL 60543-5005 | 2020-04-24 |
| 1790262434 | Dental Professionals of Illinois, P.C. | Dentist | 1402 S Us Highway 12, Fox Lake, IL 60020-1252 | 2018-07-25 |
| 1043609167 | Dental Professionals of Illinois, P.C. | Dentist | 9990 W 190th St, Suite D, Mokena, IL 60448-8188 | 2015-01-13 |
| 1144623273 | Dental Professionals of Illinois, P.C. | Dentist | 540 W Walnut St, Oglesby, IL 61348-1400 | 2014-10-03 |
| 1053713966 | Dental Professionals of Illinois, P.C. | Dentist | 1411 W Lane Rd Ste B, Machesney Park, IL 61115 | 2014-09-23 |
| 1346651577 | Dental Professionals of Illinois, P.C. | Dentist | 1490 Douglas Rd, Oswego, IL 60543-5106 | 2014-05-09 |
| 1972925584 | Dental Professionals of Illinois, P.C. | Dentist | 6631 Grand Ave Ste 1, Gurnee, IL 60031-5284 | 2014-01-16 |
| 1386985380 | Dental Professionals of Illinois, P.C. | Dentist | 368 W. Washington St., East Peoria, IL 61611 | 2013-03-15 |
| 1871842112 | Dental Professionals of Illinois, P.C. | Dentist | 12605 Troxler Ave, Highland, IL 62249 | 2012-08-31 |
| 1821242603 | Dental Professionals of Illinois, P.C. | Dentist | 1840 Dekalb Ave, Suite B, Sycamore, IL 60178 | 2008-11-06 |
| Street Address |
2740 PRAIRIE CROSSING DRIVE |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| 1952523284 | Dental Professionals of Illinois, P.C. | Dentist | 3820 Wabash Ave, Springfield, IL 62711 | 2007-05-03 |
| Find all providers in zip 62711 | ||||
| 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 | 62711 |
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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.