SIGNATURE FAMILY DENTAL (NPI# 1306401591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306401591 |
| Entity Type | Organization |
| Organization Name | SIGNATURE FAMILY DENTAL |
| Practice Address |
1170 Belt Line Rd Collinsville IL 62234-4372 |
| Practice Telephone | 6183451400 |
| Mailing Telephone | 6183451400 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |
| Authorized Official Name | HEATHER DANIELLE MAHASSEK (OWNER) |
| Authorized Official Telephone | 6187092934 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | INDIVIDUAL NPI | 1003291162 | 01 |
| Street Address |
1170 BELT LINE RD |
| City | COLLINSVILLE |
| State | IL |
| Zip Code | 62234-4372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477640449 | David Parke Maier | Dentist | 1170 Belt Line Rd, Collinsville, IL 62234-4372 | 2006-10-09 |
| 1003291162 | Heather Danielle Taylor | Dentist | 1170 Belt Line Rd, Collinsville, IL 62234-4372 | 2015-07-29 |
| 1215147970 | David P Maier Dmd PC | Clinic/Center | 1170 Belt Line Rd, Collinsville, IL 62234-4372 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730791005 | Kendall Kotter | Pharmacist | 401 Beltline Rd, Collinsville, IL 62234 | 2020-08-18 |
| 1851804207 | Apex Physical Therapy, LLC | Clinic/Center | 1095 Beltine Rd., Ste. 400, Collinsville, IL 62234 | 2017-11-08 |
| 1205361110 | Pc Associates, LLC | Family Medicine | 1095 Beltline Road, Suite 500, Collinsville, IL 62234 | 2017-04-28 |
| 1538405451 | Joan M Polwort | Pharmacist | 801 Braidwood Ct, Collinsville, IL 62234 | 2012-12-20 |
| 1275818080 | Stephen Scott Branding | Pharmacist | 401 Beltline Rd., Collinsville, IL 62234 | 2011-10-13 |
| 1447534417 | Lindsay Eakin | Pharmacist | 401 Beltline, Collinsville, IL 62234 | 2011-10-07 |
| 1700171568 | Patrick Joseph Swierczek | Social Worker | 820 St. Louis Rd Apt#232, Collinsville, IL 62234 | 2011-06-09 |
| 1366670887 | Susan M. Smith Dc LLC | Chiropractor | 226 South Morrison, Collinsville, IL 62234 | 2009-06-23 |
| 1649418492 | Lynette M Patton | Counselor | 415 W Main St Ste 3, Collinsville, IL 62234 | 2009-02-02 |
| 1558506626 | Kimberly Jean Miller | Counselor | Meadow Heights Professional Park, Suite 2b, Collinsvile, IL 62234 | 2008-12-03 |
| Find all providers in zip 62234 | ||||
| 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 |
|---|---|---|---|---|
| 1770013948 | Brandon Prior | Dentist | 1099 Belt Line Rd Ste J-k, Collinsville, IL 62234-4380 | 2017-06-19 |
| 1679925614 | Jaime Woodall | Dentist | 4721 Kings Mountain Rd, Collinsville, VA 24078-1274 | 2016-07-01 |
| 1770883688 | Collinsville Family Dental | Dentist | 9171 A, Old Hwy 19n, Collinsville, MS 39325 | 2010-10-26 |
| 1801932835 | Michael N Schaulat | Dentist | 308 West Clay Street, Collinsville, IL 62234 | 2007-01-29 |
| 1649322561 | Charles Seymour Borden IIi | Dentist | 724 Saint Louis Rd, Collinsville, IL 62234-2032 | 2007-01-18 |
| 1649372327 | Ronald A Zambaldi | Dentist | 3 Collinsport Dr, Collinsville, IL 62234 | 2006-09-02 |
| 1629080866 | Melissa Bowler | Dentist | 1310 W Main St, Collinsville, OK 74021-3012 | 2006-08-13 |
| 1205841939 | Denise J Unterbrink | Dentist | 2200 Daniels Creek Rd, Collinsville, VA 24078 | 2006-07-30 |
| 1912525205 | Jessica Khiet Quach | Dentist | 4940 Kings Mountain Rd, Collinsville, VA 24078-1812 | 2020-07-13 |
| 1477110963 | Spring Dental Collinsville, Pllc | Dentist | 1111 W Main St, Collinsville, OK 74021-3112 | 2019-05-21 |
| Find all providers in COLLINSVILLE | ||||
| City | COLLINSVILLE |
| Zip Code | 62234 |
Please comment or provide details below to improve the information on SIGNATURE FAMILY DENTAL.
| 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.