LIFETIME DENTAL CARE OF ILLINOIS, PC (NPI# 1801018270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801018270 |
| Entity Type | Organization |
| Organization Name | LIFETIME DENTAL CARE OF ILLINOIS, PC |
| Other Organization Name | BAYTOWNE DENTAL CENTER |
| Practice Address |
907 W Marketview Unit 11 Champaign IL 61822 |
| Practice Telephone | 2173555220 |
| Practice Fax Number | 2173555226 |
| Mailing Telephone | 2173555220 |
| Mailing Fax Number | 2173555226 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | AMY KROEGER (INS COOD) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Baytowne 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 |
| 1720290638 | Lifetime Dental Care of Illinois, PC | Dentist | 411 Keokuk Street, Lincoln, IL 62656 | 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 |
| 1801018197 | Lifetime Dental Care of Illinois, PC | Dentist | 2707 Sycamore Road, Dekalb, IL 60115 | 2007-05-03 |
| Street Address |
907 W MARKETVIEW UNIT 11 |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
| 1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
| 1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
| 1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
| 1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
| 1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
| 1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
| 1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| Find all providers in zip 61822 | ||||
| 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 |
|---|---|---|---|---|
| 1295268019 | Mountain Bay Dental LLC | Dentist | 3510 Marianna Dr, Champaign, IL 61822-9502 | 2017-04-08 |
| 1982094462 | Familia Dental Champaign LLC | Dentist | 1907 W Spfld Ave, Champaign, IL 61821-3067 | 2015-02-04 |
| 1205245693 | Illini Smiles Dental Care PC | Dentist | 201 W Springfield Ave Ste 506, Champaign, IL 61820-6383 | 2014-08-11 |
| 1306152806 | Tania G Lodhi | Dentist | 1902 N Prospect Ave, Suite 1, Champaign, IL 61822-1411 | 2010-08-23 |
| 1154651628 | Michael R Ruffatto | Dentist | 1202 Harrington Dr, Champaign, IL 61821-6514 | 2010-01-06 |
| 1407005879 | Promise Healthcare Nfp | Dentist | 819 Bloomington Road, Champaign, IL 61820 | 2008-09-10 |
| 1851540330 | Central Illinois Oral and Maxiofacial Surgery, PC | Dentist | 14 E Anthony Dr Ste C, Champaign, IL 61820-2749 | 2008-09-09 |
| 1407002165 | Nikkole Patterson | Dentist | 3101 Village Office Pl, Champaign, IL 61822-7673 | 2008-08-13 |
| 1407010176 | Douglas M Wallen | Dentist | 2502 Galen Dr, Suite 103, Champaign, IL 61821-7045 | 2008-07-11 |
| 1275703175 | Thomas E. Standley, Dmd, PC | Dentist | 30 E Green St, Suite 1, Champaign, IL 61820-7905 | 2008-03-06 |
| Find all providers in CHAMPAIGN | ||||
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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.