Organization · Type 2 NPI

Familia Dental Springfield LLC

Dental Clinic/Center · Springfield, IL

NPI number 1780974568 Active

Practice location

802 N 9th St
Springfield, IL 62702-6309

Call (888) 988-4066 Map

Fax (847) 496-7603

Mailing address

2050 E Algonquin Rd, Suite 610
Schaumburg, IL 60173-4166

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry	1223G0001X	None listed
Dental Clinic/Center Primary	261QD0000X	None listed

Dental Clinic/Center: Definition to come...

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NPI record

NPI: 1780974568
Entity type: Organization (Type 2)
Issued: Apr 13, 2011
Last updated: Oct 21, 2021
Status: Active

Other names

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Familia Dental · doing business as
Familia Dental · doing business as

Authorized official

Mr. Brandon Alexander Taylor, CPCS
Credentialing Payer Relations MGR
(847) 453-7396

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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 1780974568

Familia Dental Springfield LLC's National Provider Identifier is 1780974568, issued on Apr 13, 2011. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Springfield, IL. The record was last updated on Oct 21, 2021.