FAMILIA DENTAL MOLINE LLC (NPI# 1588084479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588084479 |
| Entity Type | Organization |
| Organization Name | FAMILIA DENTAL MOLINE LLC |
| Other Organization Name | FAMILIA DENTAL |
| Practice Address |
1102 4th Ave Moline IL 61265 |
| Mailing Address |
2050 E Algonquin Rd Suite 610 Schaumburg IL 60173-4144 |
| Practice Telephone | 8889884066 |
| Practice Fax Number | 8474967603 |
| Mailing Telephone | 8477011454 |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |
| Authorized Official Name | DR. KOUSHAN AZAD (PRESIDENT) |
| Authorized Official Telephone | 8477011454 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Familia Dental | Doing Business As Name - Organization |
| Street Address |
1102 4TH AVE |
| City | MOLINE |
| State | IL |
| Zip Code | 61265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417564188 | Sangin Lim | Dentist | 1102 4th Ave, Moline, IL 61265-1231 | 2020-09-28 |
| 1912524265 | Lauren Halloran | Dentist | 1102 4th Ave, Moline, IL 61265-1231 | 2020-07-02 |
| 1922622943 | Aldo L Guevara | Dentist | 1102 4th Ave, Moline, IL 61265-1231 | 2020-06-05 |
| 1962914317 | Arshita Pravinchandra Patel | Dentist | 1102 4th Ave, Moline, IL 61265-1231 | 2017-10-25 |
| 1376063990 | Roshini Durga Paruchuri | Dentist | 1102 4th Ave, Moline, IL 61265-1231 | 2017-06-24 |
| 1629522891 | Janna Keiko Kawamura | Dentist | 1102 4th Ave, Moline, IL 61265-1231 | 2016-08-05 |
| 1619350212 | Lauren Pass | Dentist | 1102 4th Ave, Moline, IL 61265-1231 | 2015-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861035438 | Ora Orthopedics, PC | Orthopaedic Surgery | 510 Valley View Drive, Moline, IL 61265 | 2019-10-25 |
| 1598231698 | Secure Dental Vi | Dentist | 106 16th St, Unit #90, Moline, IL 61265 | 2018-10-17 |
| 1487152088 | Fjellheim P.c | Chiropractor | 1535 47th Avenue, Suite 5, Moline, IL 61265 | 2018-01-29 |
| 1326567199 | Elizabeth Ann Teichler | Respiratory Therapist, Registered | 4360 7th Street, Moline, IL 61265 | 2017-09-13 |
| 1497279913 | Caroline M Mather | Behavioral Analyst | 2430 6th Avenue, Moline, IL 61265 | 2017-07-26 |
| 1639625239 | Elizabeth Anderson | Nurse's Aide | 4319 26th Ave Apt 1, Moline, IL 61265 | 2016-09-01 |
| 1437604154 | Lindsey Bollaert | Nurse Practitioner | 1100 36th Ave, Moline, IL 61265 | 2016-08-23 |
| 1437541869 | Divvymed, LLC | Pharmacy | 4300 44th Ave, Moline, IL 61265 | 2015-02-23 |
| 1477955250 | Todd Stone | Nurse Practitioner | 1100 3th Avenue, Moline, IL 61265 | 2014-09-23 |
| 1033485305 | Moe Phyu Tun | Radiology | 615 Valley View Dr Ste 202, Moline, IL 61265 | 2012-03-30 |
| Find all providers in zip 61265 | ||||
| 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 |
|---|---|---|---|---|
| 1245607209 | Mark Stephen Stumphy | Dentist | 3727 39th St, Moline, IL 61265-5407 | 2015-08-26 |
| 1992048912 | Secure Dental II | Dentist | 4601 16th St, Unit 12, Moline, IL 61265-7000 | 2013-03-27 |
| 1881966042 | Troy Roeder Dds PC | Dentist | 5030 38th Ave, Suite 1, Moline, IL 61265-6717 | 2012-02-03 |
| 1780832519 | Maura Josephine Vroman | Dentist | 2131 1st Street A, Moline, IL 61265-7745 | 2008-09-04 |
| 1376703264 | Rick Theuninck Leppo | Dentist | 1631 Avenue of The Cities, Moline, IL 61265-4856 | 2008-06-13 |
| 1417137142 | Jeffery Scott Doroba | Dentist | 518 19th Ave, Moline, IL 61265-3760 | 2007-11-09 |
| 1770792640 | Casey Patrick Kenney | Dentist | 4538 3rd St, Moline, IL 61265-6104 | 2007-05-21 |
| 1508086943 | Chad Joseph Versluis | Dentist | 3422 River Dr, Moline, IL 61265-1747 | 2007-04-26 |
| 1154451847 | G.a.prickett,d.d.s.,g.j.goebel,d.d.s.&g.a.solis,d.d.s.,ltd. | Dentist | 7017 John Deere Pkwy, Suite 2 B, Moline, IL 61265-8072 | 2007-03-06 |
| 1649305921 | Hawkeye Dental Creations | Dentist | 615 35th Avenue, Moline, IL 61265 | 2007-02-23 |
| Find all providers in MOLINE | ||||
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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.