Smalltown Dental Jacksonville PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMALLTOWN DENTAL JACKSONVILLE PLLC

Practice address

505 W College Ave
Jacksonville, IL 62650-2405

Phone

(217) 245-5319

NPI assigned

Aug 26, 2026

Last updated

Aug 26, 2026By the provider in NPPES

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 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.

• Randall Evert Lawson, D.D.S.

  • General Practice Dentistry
  • Jacksonville, IL
  • NPI 1730151176
  NPD (past)

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

{
    "created_epoch": "1787702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1043127707",
    "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": "505 W COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502405",
            "telephone_number": "217-245-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALLTOWN DENTAL JACKSONVILLE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMALLTOWN DENTAL MANAGEMENT LLC",
        "enumeration_date": "2026-08-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "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": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Sibert, RD
• Cynthia Simpson, MD
• Siu Physicians & Surgeons, Inc
• Denise L Skinner, LCPC
• Michael Scott Slinkard, COTA/L
• Smile Experts Dental Associates
• Callie Soer, DMD
• Julia Anne Speakman, LCSW
• Devin Scott Spears, M.S., A.T.,C.
• Misty Dawn Spencer

• General Practice Dentistry in Jacksonville, IL
• Providers in Jacksonville, 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 26, 2026; 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.