DR. DAVID EFAW (NPI# 1700862877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700862877 |
| Entity Type | Individual |
| Full Name | DR. DAVID EFAW |
| Credential | MD, DDS |
| Practice Address |
109 N Regency Dr Bloomington IL 61701-3515 |
| Practice Telephone | 3096632526 |
| Practice Fax Number | 3096634788 |
| Mailing Telephone | 3096632526 |
| Mailing Fax Number | 3096634788 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2019-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
019023548 | IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DEA | BB9276278 | 01 |
| Street Address |
109 N REGENCY DR |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710985759 | Drs Doran Capodice Efaw & Ocheltree LLC | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2005-07-13 |
| 1114363579 | Anthony Mitchell Elger | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2013-05-13 |
| 1205892973 | Thomas Charles Ocheltree Jr. | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2006-04-21 |
| 1376529750 | Stephen N Doran | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2005-12-19 |
| 1053397612 | Jack Capodice Jr. | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2005-12-15 |
| 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 | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891786224 | Thomas Maurice Keane Jr. | Dentist | 8900 Penn Ave So., Suite 211, Bloomington, MN 55431 | 2005-11-03 |
| 1114363579 | Anthony Mitchell Elger | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2013-05-13 |
| 1205892973 | Thomas Charles Ocheltree Jr. | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2006-04-21 |
| 1376529750 | Stephen N Doran | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2005-12-19 |
| 1053397612 | Jack Capodice Jr. | Dentist | 109 N Regency Dr, Bloomington, IL 61701-3515 | 2005-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558582148 | Joel Schwartz | Dentist | 801 S Paulina, Mc 621, Chicago, IL 60612 | 2007-05-01 |
| 1982822912 | Oral and Maxillofacial Surgery Affiliates Ltd. | Dentist | 111 S Washington St., Ste 101, Park Ridge, IL 60068-4203 | 2007-04-23 |
| 1700920113 | Ordie H. King Jr. | Dentist | 6111 Vollmer Ln, Godfrey, IL 62035-1062 | 2007-02-18 |
| 1568514248 | Mark W Lingen | Dentist | 150 Harvester Dr Ste 300, Burr Ridge, IL 60527-5965 | 2007-01-16 |
| 1861402893 | Dennis Gerald Boyer | Dentist | 183 S Bloomingdale Rd Ste 205, Bloomingdale, IL 60108-1400 | 2006-08-09 |
| 1871516088 | Sara C Gordon | Dentist | 801 S Paulina Street, Dept of Oral Medicine Uic College of Dentistry Mc 838, Chicago, IL 60612-7213 | 2006-07-26 |
| 1114967205 | Jerome E. Schoen | Dentist | 303 N Northwest Hwy, Barrington, IL 60010-3396 | 2006-06-07 |
| 1558312371 | James A Morrone | Dentist | 120 Oakbrook Ctr, Suite 700, Oak Brook, IL 60523-1806 | 2006-05-15 |
| 1205808854 | Reza Mostofi | Dentist | 3407 W Bryn Mawr Ave, Chicago, IL 60659-3450 | 2006-02-06 |
| 1710413091 | Kathleen Higgins | Dentist | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2017-05-05 |
| Find all providers with the same taxonomy | ||||
| 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.