Smalltown Dental Bloomington on Maloney

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMALLTOWN DENTAL BLOOMINGTON ON MALONEY

Practice address

2433 Maloney Dr
Bloomington, IL 61704-3750

Phone

(309) 662-9042

NPI assigned

Mar 14, 2023

Organization subpart

Yes

Parent organization

SMALLTOWN DENTAL MANAGEMENT LLCAs reported in NPPES

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

Authorized official

Name

Luke Overcash

Title

Cio

Phone

(309) 370-5853

Specialties & licenses 1

Addresses

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Holly J. Houska, D.M.D.

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1982767695
  NPD (past)
• Mark R. Houska, D.M.D.

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1790848406
  NPD (past)
• Aaron Michaels, D.M.D.

  • Dentist
  • Bloomington, IL
  • NPI 1912358797
  NPD (past)
• Grace A Mosley, DMD

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1659060432
  NPD (past)

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1023719341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 4TH AVE STE 110",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615503401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2433 MALONEY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043750",
            "telephone_number": "309-662-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALLTOWN DENTAL BLOOMINGTON ON MALONEY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMALLTOWN DENTAL MANAGEMENT LLC",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "OVERCASH",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "309-370-5853"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sleep Solutions of Central Illinois
• Sleep Solutions of Central Illinois LLC
• Sarah Sleeter, MS, CCC-SLP
• Barry Slotky, MD
• Grace Mragret Slowikowski
• Smart Health & Wellness Center, LLC
• Barbarette Smith, LPC
• Elaine Smith, R.N.
• Glen B Smith, M.D.
• Jacob Smith, PA-C, ATC

• General Practice Dentistry in Bloomington, IL
• Providers in Bloomington, 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 Mar 14, 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.