NPIMap

Organization Active NPI

Dental Professionals of Illinois, P.C.

Doing business as Ridgeview Family Dental P.C.

  • General Practice Dentistry
  • McHenry, IL
National Provider Identifier
1013695915
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Doing business as
Ridgeview Family Dental P.C.
Practice address
3617 Municipal Dr
McHenry, IL 60050-5434
Phone
(815) 344-2282
NPI assigned
Jul 10, 2023
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Cemyira McDougal
Title
Credentialing Coordinator
Phone
(217) 764-8609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3617 Municipal Dr
McHenry, IL 60050-5434

Mailing address

3617 Municipal Dr
McHenry, IL 60050-5434

Other names 1

  • Ridgeview Family Dental P.C. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Illinois PC75 organizations share this tax ID, including this one
Part of
Dental Professionals of Illinois PC

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

3617 Municipal Dr
McHenry, IL 60050
Phone (815) 344-2282

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1013695915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 MUNICIPAL DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600505434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 MUNICIPAL DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600505434",
            "telephone_number": "815-344-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF ILLINOIS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF ILLINOIS, P.C.",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgeview Family Dental P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.