LIFETIME DENTAL CARE OF ILLINOIS, PC (NPI# 1720290638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720290638 |
| Entity Type | Organization |
| Organization Name | LIFETIME DENTAL CARE OF ILLINOIS, PC |
| Other Organization Name | LINCOLN DENTAL CENTER |
| Practice Address |
411 Keokuk Street Lincoln IL 62656 |
| Practice Telephone | 2177328818 |
| Practice Fax Number | 2177329703 |
| Mailing Telephone | 2177328818 |
| Mailing Fax Number | 2177329703 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | AMY KROEGER (INS COOD) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFETIME DENTAL CARE OF ILLINOIS, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Lincoln Dental Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487867750 | Lifetime Dental Care of Illinois, PC | Dentist | 1366 E Main, Carbondale, IL 62901 | 2007-05-07 |
| 1689887952 | Lifetime Dental Care of Illinois, PC | Dentist | 2633 Chatham Road, Suite A, Springfield, IL 62704 | 2007-05-07 |
| 1700099066 | Lifetime Dental Care of Illinois, PC | Dentist | 2943 W White Oaks Drive, Springfield, IL 62704 | 2007-05-07 |
| 1659583656 | Lifetime Dental Care of Illinois, PC | Dentist | 700 N Keller, Effingham, IL 62401 | 2007-05-04 |
| 1487866919 | Lifetime Dental Care of Illinois, PC | Dentist | 7310 N. Villa Lake Drive, Suite B, Peoria, IL 61614 | 2007-05-04 |
| 1023230281 | Lifetime Dental Care of Illinois, PC | Dentist | 1001 E Main, Carbondale, IL 62901 | 2007-05-03 |
| 1376765776 | Lifetime Dental Care of Illinois, PC | Dentist | 703b S Neil, Champaign, IL 61820 | 2007-05-03 |
| 1396967741 | Lifetime Dental Care of Illinois, PC | Dentist | 1200 W Jackson, Macomb, IL 61455 | 2007-05-03 |
| 1801018270 | Lifetime Dental Care of Illinois, PC | Dentist | 907 W Marketview, Unit 11, Champaign, IL 61822 | 2007-05-03 |
| 1801018197 | Lifetime Dental Care of Illinois, PC | Dentist | 2707 Sycamore Road, Dekalb, IL 60115 | 2007-05-03 |
| Street Address |
411 KEOKUK STREET |
| City | LINCOLN |
| State | IL |
| Zip Code | 62656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437678943 | Carissa Jo O'donoghue | Speech-Language Pathologist | 1000 Railer Way, Lincoln, IL 62656 | 2017-09-15 |
| 1083972012 | Cynthia Dorchinecz | Speech-Language Pathologist | 200 Fifth Street, Lincoln, IL 62656 | 2012-04-27 |
| 1104100114 | Jan E Fehrenbacher | Pharmacist | 603 Woodlawn, Lincoln, IL 62656 | 2011-10-10 |
| 1053633263 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 124-126 S. Chicago Street, Lincoln, IL 62656 | 2010-02-16 |
| 1649428756 | Diane E Ulrich | Dentist | 400 N. Chicago St, Lincoln, IL 62656 | 2008-09-03 |
| 1922202944 | Robert C Miller | Dentist | 217 S Kickapoo St, Lincoln, IL 62656 | 2007-06-13 |
| 1982734539 | Wal-mart Stores, Inc. Dba Wal-mart | Technician/Technologist | 825 Malerich Dr., Lincoln, IL 62656 | 2007-03-06 |
| 1861571663 | David R Hepler II | Chiropractor | 2000 Pulaski Street, Lincoln, IL 62656 | 2006-11-03 |
| 1477561793 | Raymond Todd Nobbe | Optometrist | 1400 Woodlawn Road, Lincoln, IL 62656 | 2006-08-03 |
| 1598710345 | Jak Enterprises Inc | Optometrist | 1477 Woodlawn Rd, Lincoln, IL 62656 | 2006-05-23 |
| Find all providers in zip 62656 | ||||
| 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 |
|---|---|---|---|---|
| 1346854692 | Justin Marino | Dentist | 6 Blackstone Valley Pl Bldg 3, Lincoln, RI 02865-1179 | 2020-09-03 |
| 1053922534 | Chelsea Glissman | Dentist | 751 Sterling Pkwy Ste 100, Lincoln, CA 95648-7313 | 2020-08-10 |
| 1275150401 | Vy T Vu | Dentist | 6835 S 27th St Ste 2, Lincoln, NE 68512-4824 | 2020-07-03 |
| 1326664483 | Robert Kirkland | Dentist | 1919 S 40th St Ste 200, Lincoln, NE 68506-5247 | 2020-06-24 |
| 1265058861 | Christine Ruth Bergman | Dentist | 2121 S 70th Street, Lincoln, NE 68506 | 2020-06-19 |
| 1881218428 | South Lincoln Family Dentistry LLC | Dentist | 2121 S. 70th Street, Lincoln, NE 68506 | 2020-05-29 |
| 1619529617 | Brenton Joseph Matulka | Dentist | 575 Fallbrook Blvd Ste 107, Lincoln, NE 68521-9040 | 2019-07-10 |
| 1912472192 | Lonnie R. Flagtwet, Dds | Dentist | 7121 Stephanie Ln Ste 112, Lincoln, NE 68516-5324 | 2018-10-03 |
| 1033695366 | Callie R Krajicek | Dentist | Williamsburg Dental 6930 L St., Ste B, Lincoln, NE 68510-6851 | 2018-07-19 |
| 1659857522 | Chantel Rueb Keller | Dentist | 2915 Channel Dr, Lincoln, NE 68516-4985 | 2018-07-13 |
| Find all providers in LINCOLN | ||||
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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.