Active NPI
Kathy Arkwell, D.M.D., M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Peoria, IL
National Provider Identifier
1033581103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 019016857
- Practice address
- 2425 W Cornerstone CT
Peoria, IL 61614-2494 - Phone
- (309) 692-3000
- Fax
- (309) 692-4477
- NPI assigned
- Oct 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 019016857 | IL | Primary |
Addresses
Primary practice location
2425 W Cornerstone CT
Peoria, IL 61614-2494
Mailing address
2425 Cornerstone CT
Peoria, IL 61614
Phone (309) 692-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019016857 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445990400000",
"number": "1033581103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 CORNERSTONE CT",
"city": "PEORIA",
"state": "IL",
"postal_code": "61614",
"telephone_number": "309-692-3000",
"fax_number": "309-692-4477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 W CORNERSTONE CT",
"city": "PEORIA",
"state": "IL",
"postal_code": "616142494",
"telephone_number": "309-692-3000",
"fax_number": "309-692-4477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARKWELL",
"first_name": "KATHY",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-28",
"last_updated": "2015-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": "019016857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.