Catherine E. Cavanaugh, D.D.S,, M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019023172 Issued in IL

Practice address

391 W Weaver Rd
Forsyth, IL 62535-9764

Phone

(217) 872-0623

Fax

(217) 872-0525

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1013098045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 STEVENS CREEK BLVD",
            "city": "FORSYTH",
            "state": "IL",
            "postal_code": "625359741",
            "telephone_number": "217-875-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 W WEAVER RD",
            "city": "FORSYTH",
            "state": "IL",
            "postal_code": "625359764",
            "telephone_number": "217-872-0623",
            "fax_number": "217-872-0525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 N 9th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627026309",
            "country_code": "US",
            "telephone_number": "217-679-2896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1353 E Mound Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625263680",
            "country_code": "US",
            "telephone_number": "217-872-0623",
            "fax_number": "217-872-0525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "CATHERINE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S,, M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12014549A",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019023172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blunck2604Llc
• Barbara M Bolin, LCPC, LMFT
• Larry D Bolyard
• Lisa Ann Brooks, OTR/L
• Keith Franklin Bumgardner Jr., DPT
• Ha Young Cho, MD
• Leah Marie Cummings, APRN, FNP-C
• Karen S Cycotte, O.D.
• Nicole Dalton, P.A.
• Dean Ryan Davis, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Forsyth, IL
• Providers in Forsyth, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.