Ginger Creek Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025281 Issued in IL

Legal business name

GINGER CREEK DENTAL LLC

Practice address

24 Ginger Creek Pkwy
Glen Carbon, IL 62034-3502

Phone

(618) 692-1110

NPI assigned

Aug 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. David Guilbeault, D.M.D.

Title

Dentist

Phone

(618) 692-1110

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1023323623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GINGER CREEK PKWY",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 GINGER CREEK PKWY",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343502",
            "telephone_number": "618-692-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GINGER CREEK DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "GUILBEAULT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "618-692-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Gentry, BSN, RN
• Marshall Gevers, DC
• Emily Grace Gibbs, RBT
• Kelsey Giger
• Victoria Elise Ginder, LCSW, MSW
• Harlan Lorenzo Glasper III
• Glen Carbon Fire Protection District
• Glen Ed Pharmacy LLC
• Kristin Goeb
• Sarah Goshorn

• General Practice Dentistry in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.