NPIMap

Organization Active NPI

Jill Kinsella DMD LLC

  • Dentist
  • Scott Afb, IL
National Provider Identifier
1043589526
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027404 Issued in IL
Legal business name
JILL KINSELLA DMD LLC
Practice address
703 Seibert Rd.
Suite 5
Scott Afb, IL 62225
Phone
(618) 744-1969
Fax
(618) 744-1986
NPI assigned
Dec 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Jill Anne Kinsella, DMDNPI 1558560623
Title
Owner/Dentist
Phone
(618) 744-1969

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019027404 IL Primary

Addresses

Primary practice location

703 Seibert Rd.
Suite 5
Scott Afb, IL 62225

Mailing address

703 Seibert Rd.
Suite 5
Scott Afb, IL 62225
Phone (618) 744-1969

National Provider Directory

National Provider Directory

Locations

703 Seibert Rd
Ste 5
Scott AFB, IL 62225
Phone (618) 744-1969

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": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1043589526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 SEIBERT RD.",
            "address_2": "SUITE 5",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "62225",
            "telephone_number": "618-744-1969",
            "fax_number": "618-744-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 SEIBERT RD.",
            "address_2": "SUITE 5",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "62225",
            "telephone_number": "618-744-1969",
            "fax_number": "618-744-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL KINSELLA DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "KINSELLA",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "618-744-1969",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott Afb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.