PERIODONTICS OF ROCKFORD LTD. (NPI# 1295988574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295988574 |
| Entity Type | Organization |
| Organization Name | PERIODONTICS OF ROCKFORD LTD. |
| Practice Address |
1055 Featherstone Rd Rockford IL 61107 |
| Practice Telephone | 8152275858 |
| Practice Fax Number | 8152276238 |
| Mailing Telephone | 8152275858 |
| Mailing Fax Number | 8152276238 |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2008-10-30 |
| Authorized Official Name | JEFFREY V.A. BURCH (PERIODONTIST) |
| Authorized Official Telephone | 8152275858 |
| Authorized Official Credential | D.M.D., M.S. |
| Is Organization Subpart | Y |
| Parent Organization Name | PERIODONTICS OF ROCKFORD LTD. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 021002217 | IL | Dental Providers |
| Street Address |
1055 FEATHERSTONE RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548243819 | Regina B Bielkus | Psychiatry & Neurology | 1055 Featherstone Rd, Suite C, Rockford, IL 61107-5904 | 2005-11-21 |
| 1114372422 | Katrine Andreasen | Dentist | 1055 Featherstone Rd, Rockford, IL 61107 | 2016-04-25 |
| 1275864118 | Regina B Bielkus Md LLC | Psychiatry & Neurology | 1055 Featherstone Rd, Suite C, Rockford, IL 61107-5904 | 2010-01-15 |
| 1225209562 | Brandon Hull | Dentist | 1055 Featherstone Rd, Ste. B, Rockford, IL 61107-5904 | 2008-03-14 |
| 1518984293 | Paul Revis | Dermatology | 1055 Featherstone Rd, Rockford, IL 61107-5904 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700495074 | Tiffany Kimmel | Dentist | 6085 9 Mile Rd Ne, Rockford, MI 49341-7747 | 2020-07-23 |
| 1174016893 | Above & Beyond Denistry, LLC | Dentist | 364 Financial Ct Ste A, Rockford, IL 61107-6668 | 2018-06-07 |
| 1396255097 | Edwin Gonzalez Montoya | Dentist | 6585 E State St, Rockford, IL 61108-2542 | 2017-10-07 |
| 1124557228 | Alex Moore | Dentist | 6050 Brynwood Dr Ste 205, Rockford, IL 61114-6579 | 2017-06-12 |
| 1245686096 | Adriana Carolina Padron | Dentist | 275 Bienterra Trl Apt 4, Rockford, IL 61107-5882 | 2016-05-11 |
| 1275946113 | Jeffrey Heinz | Dentist | 158 Marcell Dr Ne Ste A, Rockford, MI 49341-1393 | 2014-06-09 |
| 1275872046 | Eugene Louis Bonofiglo | Dentist | 4655- 14 Mile Rd Ne, Rockford, MI 49341 | 2013-02-13 |
| 1326390113 | Apex-northwestern Dental Group LLP | Dentist | 364 Financial Ct, Suite A, Rockford, IL 61107-6668 | 2012-10-04 |
| 1285951004 | Bogdan Robert Busan | Dentist | 4035 Morsay Dr Ste 1, Rockford, IL 61107-4875 | 2010-05-03 |
| 1689800021 | Scott Strickland Dds Pllc | Dentist | 380 E. Division St., Rockford, MI 49341 | 2009-05-29 |
| Find all providers in ROCKFORD | ||||
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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.