Knox Family Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019030409 Issued in IL

Legal business name

KNOX FAMILY DENTAL LLC

Practice address

1172 Monroe St Ste 7
Galesburg, IL 61401-2554

Phone

(309) 343-9229

NPI assigned

Aug 31, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Collin Petoskey, D.D.S.

Title

Dentist/Owner

Phone

(309) 738-6224

Specialties & licenses 1

Addresses

Other names 1

• Knox Family Dental Other name

Locations

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1053893586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 MONROE ST STE 7",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012554",
            "telephone_number": "309-343-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 MONROE ST STE 7",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012554",
            "telephone_number": "309-343-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOX FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "PETOSKEY",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "309-738-6224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019030409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knox Family Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Knox Clinic Corp
• Knox Clinic Corp
• Knox Clinic Corp
• Knox Community Health Center NFP
• Knox County Hearing
• Knox Family Orthodontics LLC
• Knox OB-GYN, LTD
• Knox Warren Spec Educ District
• Courtney Sue Knuth-Galvin
• Gabriel J Koch, DO

• Dental Clinic/Center in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.