DENTAL PROFESSIONALS OF ILLINOIS, P.C. (NPI# 1447472790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447472790 |
| Entity Type | Organization |
| Organization Name | DENTAL PROFESSIONALS OF ILLINOIS, P.C. |
| Other Organization Name | COLLEGE AVENUE FAMILY DENTISTRY |
| Practice Address |
3430 College Avenue Alton IL 62002 |
| Practice Telephone | 6184655727 |
| Practice Fax Number | 6184655504 |
| Mailing Telephone | 6184655727 |
| Mailing Fax Number | 6184655504 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-01-07 |
| Authorized Official Name | LINDSAY BEARDEN (INS COOD) |
| Authorized Official Telephone | 2175405100 |
| 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 |
|---|---|
| College Avenue Family Dentistry | 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 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 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 |
| Street Address |
3430 COLLEGE AVENUE |
| City | ALTON |
| State | IL |
| Zip Code | 62002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| 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 |
|---|---|---|---|---|
| 1336679521 | Mikal Ismail Bell | Dentist | 1809 Homer Adams Pkwy Ste A, Alton, IL 62002-5606 | 2017-06-19 |
| 1033550785 | Martin F. Land | Dentist | 2800 College Ave - Bldg. 263, Southern Illinois University, School of Dental Medicine, Alton, IL 62002-4700 | 2013-07-10 |
| 1639421951 | Sscl Corp Pllc | Dentist | 1315 W. Main Ave Ste 10, Alton, TX 78573 | 2012-10-10 |
| 1457633851 | Brian Ernest Waldman | Dentist | 1410 Seminary St, Alton, IL 62002-4040 | 2011-09-13 |
| 1093018426 | Yojin Steven Chon | Dentist | 1315 W Main Ave Ste 10, Alton, TX 78573-1643 | 2010-12-07 |
| 1962614479 | James J. Reinersman D.m.d. P.C. | Dentist | 2524 State St, Alton, IL 62002-5148 | 2007-05-04 |
| 1467674002 | Affordable Dentistry Today, PC | Dentist | 3432 College Avenue, Alton, IL 62002 | 2007-05-03 |
| 1427185503 | Roy Dale Bower | Dentist | 2716 Corner Ct, Alton, IL 62002-5328 | 2007-02-27 |
| 1710037155 | James Edson Nativi | Dentist | 2418 Bloomer Dr, Alton, IL 62002-4809 | 2007-01-10 |
| 1316004310 | Terry Jon Ortman | Dentist | 4119 Humbert Rd, Alton, IL 62002-7116 | 2007-01-02 |
| Find all providers in ALTON | ||||
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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.