Organization · Type 2 NPI

Dental Professionals of Illinois, P.c.

General Practice Dentistry · Peoria, IL

NPI number 1376765818 Active

Practice location

3412 W Willow Knolls Road, Suite A
Peoria, IL 61614

Fax (309) 693-8295

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: 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.

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NPI record

NPI: 1376765818
Entity type: Organization (Type 2)
Issued: May 3, 2007
Last updated: Jan 8, 2014
Status: Active
Subpart: Yes of Dental Professionals of Illinois, P.c.

Other names

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Northgate Family Dental · doing business as

Authorized official

Lindsay Bearden
Ins Cood
(217) 540-5100

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1376765818

Dental Professionals of Illinois, P.c.'s National Provider Identifier is 1376765818, issued on May 3, 2007. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Peoria, IL. The record was last updated on Jan 8, 2014.