MARKET STREET FAMILY DENTIST, PC (NPI# 1770122194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770122194 |
| Entity Type | Organization |
| Organization Name | MARKET STREET FAMILY DENTIST, PC |
| Practice Address |
212 E Market St Troy IL 62294-1512 |
| Practice Telephone | 6186676101 |
| Mailing Telephone | 6186676101 |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2020-01-02 |
| Authorized Official Name | DR. BEAU MOODY (PRESIDENT) |
| Authorized Official Telephone | 6186676101 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
212 E MARKET ST |
| City | TROY |
| State | IL |
| Zip Code | 62294-1512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275669798 | Mark F Porter | Dentist | 212 E Market St, Troy, IL 62294-1512 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437601283 | Gateway Dental Group, LLC | Dentist | 606 Edwardsville Road, Troy, IL 62294 | 2016-10-27 |
| 1194056093 | Carol Ann Slazinik | Nurse Anesthetist, Certified Registered | 8634 Blackjack Hollow Ln, Troy, IL 62294 | 2010-01-18 |
| 1083786248 | Andrea B. Shaw, Lcsw | Social Worker | 552 Edwardsville Road, Troy, IL 62294 | 2006-11-14 |
| 1457456923 | Kurt Dick James | Dentist | 550 Edwardsville Rd, Troy, IL 62294 | 2006-09-13 |
| 1992713846 | Rhonda Beth Hanser | Dentist | 334 Bargraves Blvd, Troy, IL 62294 | 2006-08-04 |
| 1487692430 | Deborah Lea Fowler Dixon Bross | Family Medicine | 301 Edwardsville Road, Troy, IL 62294 | 2006-06-03 |
| 1225081052 | Patricia Ellen Miller | Pharmacist | 101 E Market, Troy, IL 62294 | 2006-05-19 |
| 1174576441 | Michael G Csaszar | Dentist | 7656 Plummer Business Drive, Troy, IL 62294 | 2006-05-18 |
| 1710946280 | Rodney L Lupardus | Family Medicine | 108 West Us Highway 40, Troy, IL 62294 | 2006-03-22 |
| 1992080774 | Larrah Lenn Duckworth | Pharmacist | 640 Edwardsville Rd, Troy, IL 62294 | 2011-10-12 |
| Find all providers in zip 62294 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484375 | Troy Cosmetic and Implant Dental Center Pllc | Clinic/Center | 4770 Rochester Rd Ste 106, Troy, MI 48085-4951 | 2020-10-15 |
| 1578176574 | Glowing Smiles Dental Pllc | Clinic/Center | 1551 W Big Beaver Rd Ste D14, Troy, MI 48084-3528 | 2020-08-28 |
| 1437326469 | Bryan F. Harju, Dmd Inc. | Clinic/Center | 435 Trade Sq W, Troy, OH 45373-2461 | 2008-05-08 |
| 1760012371 | Nexus Dental | Clinic/Center | 42 4th St, Troy, NY 12180-3203 | 2020-01-22 |
| 1841768975 | Hanser Dental, LLC | Clinic/Center | 334 Bargraves Blvd, Troy, IL 62294-2304 | 2018-11-07 |
| 1306334503 | Ansari Dental of Troy Pllc | Clinic/Center | 3962 Rochester Rd, Troy, MI 48083-5248 | 2018-04-24 |
| 1477911832 | Shanna Mcgettrick Dds,pc | Clinic/Center | 6804 Meadow Ct, Troy, MI 48098-2032 | 2016-02-01 |
| 1215392998 | Dentists R Us | Clinic/Center | 38865 Dequindre Rd Ste 105, Troy, MI 48083-6812 | 2015-12-22 |
| 1437559739 | Kerry J Brown, Dds | Clinic/Center | 2025 W Long Lake Rd, Suite 110, Troy, MI 48098-4100 | 2014-08-25 |
| 1477898187 | Troy Dental PC | Clinic/Center | 5 Broadway, Suite# 201, Troy, NY 12180-3226 | 2012-12-06 |
| Find all providers in TROY | ||||
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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.