EASTLAND DENTAL CENTER, LTD. (NPI# 1609134865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609134865 |
| Entity Type | Organization |
| Organization Name | EASTLAND DENTAL CENTER, LTD. |
| Practice Address |
1404 Eastland Drive Ste 101 Bloomington IL 61701 |
| Practice Telephone | 3096634711 |
| Practice Fax Number | 3096631854 |
| Mailing Telephone | 3096634711 |
| Mailing Fax Number | 3096631854 |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-04-25 |
| Authorized Official Name | MICHAEL L. MILLIGAN (PRESIDENT) |
| Authorized Official Telephone | 3096634711 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
1404 EASTLAND DRIVE STE 101 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447355383 | Surgical Associates of Bloomington, Ill,ltd | Surgery | 1404 Eastland Drive, Suite 104, Bloomington, IL 61701 | 2006-09-14 |
| 1689863904 | Associates In Dermatology Sc | Dermatology | 1404 Eastland Drive, Suite 204, Bloomington, IL 61701-3532 | 2007-10-23 |
| 1598803330 | Thomas Richard Brander | Dermatology | 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 | 2007-02-02 |
| 1619015450 | James Richard Seehafer | Dermatology | 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 | 2007-02-02 |
| 1669510400 | Lucy Nelson Wisdom | Dermatology | 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 | 2007-02-02 |
| 1326136656 | Deborah S Pitcher | Audiologist | 1404 Eastland Drive, Suite 203, Bloomington, IL 61701 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1134773419 | Fairview Clinics | Clinic/Center | 322 E. Broadway Suite E322, Bloomington, MN 55425 | 2019-07-25 |
| 1922518463 | Kids Play Sensory Gym LLC | Clinic/Center | 2010 S Yost Ave, Bloomington, IN 47403-3188 | 2017-10-11 |
| 1508146515 | Lifeview Care Co, Pllc | Clinic/Center | 3600 American Blvd W Ste 225, Bloomington, MN 55431-1079 | 2011-08-22 |
| 1356639058 | Lifeview Care,pllc | Clinic/Center | 3600 American Blvd W, Suite 225, Bloomington, MN 55431-1079 | 2011-07-14 |
| 1962646786 | Carolyn Marion Smith | Clinic/Center | 3620 N Lauren Ln, Bloomington, IN 47404-9206 | 2009-04-23 |
| 1598225328 | Action for East African People Afeap | Clinic/Center | 3701 W Old Shakopee Rd, Bloomington, MN 55431-3555 | 2019-03-20 |
| 1578028288 | Actioncare Community Clinic Inc | Clinic/Center | 10584 France Ave S, Bloomington, MN 55431-3538 | 2019-02-06 |
| 1942778097 | The Sweere Clinic LLC | Clinic/Center | 2501 W 84th St, Bloomington, MN 55431-1602 | 2018-11-07 |
| 1861858953 | Fairview Health Services | Clinic/Center | 600 W 98th St, Bloomington, MN 55420-4773 | 2016-01-06 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.