NPIMap

Organization Active NPI

Duquoin Dental Associates, LTD.

  • Dental Clinic/Center
  • Du Quoin, IL
National Provider Identifier
1043480098
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DUQUOIN DENTAL ASSOCIATES, LTD.
Practice address
1226 S Washington St
Du Quoin, IL 62832-3853
Phone
(618) 542-8832
Fax
(618) 542-9255
NPI assigned
Mar 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Dr. Isaac E Davison, D.D.S.NPI 1316117369
Title
President/Owner
Phone
(618) 542-5889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X IL Primary

Addresses

Primary practice location

1226 S Washington St
Du Quoin, IL 62832-3853

Mailing address

1226 S Washington St
PO Box 330
Du Quoin, IL 62832-3853
Phone (618) 542-8832

National Provider Directory

National Provider Directory

Locations

1226 S Washington St
Du Quoin, IL 62832
Phone (618) 542-8832

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1043480098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 S WASHINGTON ST",
            "address_2": "PO BOX 330",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628323853",
            "telephone_number": "618-542-8832",
            "fax_number": "618-542-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 S WASHINGTON ST",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628323853",
            "telephone_number": "618-542-8832",
            "fax_number": "618-542-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUQUOIN DENTAL ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "DAVISON",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "618-542-5889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Quoin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.