DR. SAM DALIRI (NPI# 1487209664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487209664 |
| Entity Type | Individual |
| Full Name | DR. SAM DALIRI |
| Credential | D.M.D |
| Practice Address |
1604 Visa Dr Normal IL 61761-2195 |
| Mailing Address |
1604 Visa Dr Unit 3 Normal IL 61761-2195 |
| Practice Telephone | 7736101041 |
| Practice Fax Number | 8159777029 |
| Mailing Telephone | 3095852522 |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.032266 | IL | Dental Providers |
| Street Address |
1604 VISA DR |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-2195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659490761 | Definitive Neurodiagnostics LLC | Specialist/Technologist, Other | 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 | 2007-03-28 |
| 1346783982 | Everyone's Family Dental Normal LLC | Dentist | 1604 Visa Dr, Ste 3, Normal, IL 61761-2195 | 2016-11-30 |
| 1134678790 | Michael Hansen | Specialist/Technologist, Other | 1604 Visa Dr, Ste 1, Normal, IL 61761 | 2016-09-23 |
| 1295281228 | Brenna Catherine Maxine Knott | Specialist/Technologist, Other | 1604 Visa Dr, Normal, IL 61761-2195 | 2016-08-30 |
| 1750766499 | Dhaval Patel | Dentist | 1604 Visa Dr, Normal, IL 61761-2195 | 2015-07-23 |
| 1467830869 | Deborah Berryman | Specialist/Technologist, Other | 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 | 2015-05-18 |
| 1184002578 | Susan Ribordy | Specialist/Technologist, Other | 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 | 2015-05-18 |
| 1447667027 | Phyllis Wilkinson | Licensed Practical Nurse | 1604 Visa Dr, Ste 2, Normal, IL 61761 | 2014-07-16 |
| 1629484324 | Brian Choi | Dentist | 1604 Visa Dr, Unit #3, Normal, IL 61761-2195 | 2014-07-02 |
| 1659782373 | Jay Sweis Dds PC | Dentist | 1604 Visa Dr, Suite 3, Normal, IL 61761-2195 | 2014-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| 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 |
|---|---|---|---|---|
| 1265609689 | Landmark Dental Group, P.C. | Dentist | 1605 Hunt Dr, Normal, IL 61761-2122 | 2008-05-14 |
| 1972621647 | James C Chow | Dentist | 1523 Fort Jesse Rd, Normal, IL 61761-0159 | 2007-03-27 |
| 1619082203 | Jeffrey Lynn Jones | Dentist | 305 S Linden St, Normal, IL 61761 | 2006-08-21 |
| 1063434124 | Gregory George Rackauskas | Dentist | 305 South Linden, Normal, IL 61761 | 2006-07-24 |
| 1750766499 | Dhaval Patel | Dentist | 1604 Visa Dr, Normal, IL 61761-2195 | 2015-07-23 |
| 1629484324 | Brian Choi | Dentist | 1604 Visa Dr, Unit #3, Normal, IL 61761-2195 | 2014-07-02 |
| 1528311354 | Andrew Scott Beer | Dentist | 1605 Hunt Dr, Normal, IL 61761-2122 | 2012-10-17 |
| 1407143407 | Jennifer Marie Burge | Dentist | 305 S Linden St, Normal, IL 61761-4901 | 2011-06-29 |
| 1326251869 | Barnes Dental Associates | Dentist | 211 Landmark Dr, Suite E-3, Normal, IL 61761-2160 | 2007-05-08 |
| 1700930096 | Bradley William Barnes | Dentist | 211 Landmark Dr, Suite E-3, Normal, IL 61761-2160 | 2007-01-23 |
| Find all providers in NORMAL | ||||
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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.