PERRYVILLE DENTIST PC (NPI# 1730547936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730547936 |
| Entity Type | Organization |
| Organization Name | PERRYVILLE DENTIST PC |
| Practice Address |
845 S Perryville Rd Unit 119 Rockford IL 61108 |
| Practice Telephone | 8473540127 |
| Mailing Telephone | 8473540127 |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |
| Authorized Official Name | JABAL R PATEL (OWNER) |
| Authorized Official Telephone | 8473540127 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.026938 | IL | Dental Providers |
| Street Address |
845 S PERRYVILLE RD UNIT 119 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982198354 | Taha Mirza | Dentist | 845 S Perryville Rd, Rockford, IL 61108-4340 | 2018-06-19 |
| 1376999292 | Henry Hackney IIi | Dentist | 845 S Perryville Rd, Rockford, IL 61108-4340 | 2016-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| 1285909200 | Rockford Wellness Corporation Sc | Chiropractor | 6019 Fincham Road, Rockford, IL 61108 | 2012-03-09 |
| Find all providers in zip 61108 | ||||
| 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 |
|---|---|---|---|---|
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| 1295192144 | Woolery Dental P.C. | Dentist | 5301 E State St Ste 306, Rockford, IL 61108-2390 | 2016-01-23 |
| 1467849679 | Christopher Lee Greenwaldt | Dentist | 845 S Perryville Rd Unit 127, Rockford, IL 61108-4340 | 2015-04-26 |
| 1427463785 | Yong Woo Lee | Dentist | 7310 Walton St, Rockford, IL 61108-4614 | 2014-06-25 |
| 1750624110 | Austriaco Dental Associates LLC | Dentist | 7310 Walton St Ste A, Rockford, IL 61108-4614 | 2013-04-03 |
| 1609173749 | Kathryn Ashley Edgcomb | Dentist | 1376 Reid Farm Rd, Rockford, IL 61107-2679 | 2011-02-25 |
| 1629393962 | Affordable Dentistry Today | Dentist | 5819 E Riverside Blvd # 21, Rockford, IL 61114-4963 | 2010-03-30 |
| 1346563525 | Modern Dental of Rockford LLC | Dentist | 1321 Sandy Hollow Rd, Rockford, IL 61109-2120 | 2010-03-02 |
| 1063667079 | Wilson Dental, PC | Dentist | 610 E. Division, Rockford, MI 49341 | 2008-11-19 |
| 1558515791 | I F Hamati Dds, PC | Dentist | 7310 Walton Street, Rockford, IL 61108 | 2008-11-14 |
| Find all providers in ROCKFORD | ||||
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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.