ROCK RIVER ORAL SURGERY & DENTAL IMPLANT CENTER LLC (NPI# 1811379142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811379142 |
| Entity Type | Organization |
| Organization Name | ROCK RIVER ORAL SURGERY & DENTAL IMPLANT CENTER LLC |
| Practice Address |
973 Featherstone Rd Suite 102 Rockford IL 61107-5912 |
| Practice Telephone | 8153991234 |
| Practice Fax Number | 8153992423 |
| Mailing Telephone | 8153991234 |
| Mailing Fax Number | 8153992423 |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |
| Authorized Official Name | SHEA MCCUE (ORAL SURGEON/OWNER) |
| Authorized Official Telephone | 8153991234 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
019030148 | WI | Ambulatory Health Care Facilities |
| Street Address |
973 FEATHERSTONE RD SUITE 102 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467555961 | Maxim Healthcare Services, Inc. | Home Health | 973 Featherstone Rd, Suite 210, Rockford, IL 61107-5912 | 2006-09-07 |
| 1396291324 | Clifton Health Systems LLC | Family Medicine | 973 Featherstone Rd, Suite 340, Rockford, IL 61107-5912 | 2016-08-30 |
| 1417134701 | Rockford Regional Specialty Lab | Clinical Medical Laboratory | 973 Featherstone Rd, Suite 101, Rockford, IL 61107-5912 | 2008-01-29 |
| 1891974234 | Morris Marc Soriano Md Ltd | Neurological Surgery | 973 Featherstone Rd, Suite360, Rockford, IL 61107-5912 | 2007-11-02 |
| 1750502464 | Fertility & Reproductive Endocrinology Specialists | Obstetrics & Gynecology | 973 Featherstone Rd, Suite 100, Rockford, IL 61107-5912 | 2007-05-01 |
| 1881728129 | Jacek W Graczykowski | Obstetrics & Gynecology | 973 Featherstone Rd, Suite 100, Rockford, IL 61107-5912 | 2007-03-16 |
| 1487788006 | Chiravudh Sawetawan | Obstetrics & Gynecology | 973 Featherstone Rd, Suite 100, Rockford, IL 61107-5912 | 2007-03-15 |
| 1831223593 | Shelley A Rosander | Nurse Practitioner | 973 Featherstone Rd, Suite 100, Rockford, IL 61107-5912 | 2007-03-15 |
| 1568510006 | Morris Marc Soriano | Neurological Surgery | 973 Featherstone Rd, Suite 360, Rockford, IL 61107-5912 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881808053 | Oral and Maxillofacial Surgery Specalists Ltd. | Clinic/Center | 4035 Morsay Dr., Rockford, IL 61107-4871 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427605351 | The Bloom Oral Surgery, P.C. | Clinic/Center | 219 N Hammes Ave Ste 1, Joliet, IL 60435-8145 | 2019-08-26 |
| 1528543121 | Joms LLC | Clinic/Center | 10 Martin Ave Ste 164, Naperville, IL 60540-6563 | 2018-09-28 |
| 1750861209 | Winterset Dental Care PC | Clinic/Center | 8559 S Pulaski Rd Ste 103, Chicago, IL 60652-3643 | 2018-08-15 |
| 1679070189 | Lakeside Oral & Implant Surgery Institute, PC | Clinic/Center | 5758 S Maryland Ave # 4h, Chicago, IL 60637-1426 | 2018-04-11 |
| 1962753210 | Millennium Surgical, Inc | Clinic/Center | 5978 S Archer Ave, Chicago, IL 60638-2817 | 2012-09-26 |
| 1851551642 | Alan Andreas Harvey | Clinic/Center | 2500 Ridge Ave Ste 302, Evanston, IL 60201-2477 | 2008-06-15 |
| 1962599605 | Affiliated Oral & Maxillofacial Surgeons Ltd | Clinic/Center | 3438 N Old Arlington Heights Rd, Arlington Heights, IL 60004 | 2006-10-06 |
| 1437703113 | Shady Oak Dental LLC Oral and Maxillofacial Surgeons of Northwest Il | Clinic/Center | 208 N Walnut Ave, Forreston, IL 61030-9330 | 2019-07-30 |
| 1598250995 | Periodontics and Implant Dentistry LLC | Clinic/Center | 8559 S Pulaski Rd, Chicago, IL 60652-3643 | 2018-06-27 |
| 1205288982 | Lakeside Oral & Facial Surgery Institute | Clinic/Center | 2500 Ridge Ave, Suite 302, Evanston, IL 60201-2455 | 2016-07-06 |
| Find all providers with the same taxonomy | ||||
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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.