NPIMap

Organization Active NPI

Jesek & Willhite Family Dental Care Center

  • General Practice Dentistry
  • Decatur, IL
National Provider Identifier
1063454833
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JESEK & WILLHITE FAMILY DENTAL CARE CENTER
Practice address
3040 S Mount Zion Rd
Decatur, IL 62521-9771
Phone
(217) 864-4494
Fax
(217) 864-4486
NPI assigned
Jun 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Warren F Jesek, DDSNPI 1235350232
Title
Managing Partner
Phone
(217) 864-4494

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
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3040 S Mount Zion Rd
Decatur, IL 62521-9771

Mailing address

3040 S Mount Zion Rd
Decatur, IL 62521-9771
Phone (217) 864-4494

Other names 1

  • JESEK, WILLHITE & GRIFFIN FAMILY DENTAL CARE CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

3040 S Mount Zion Rd
Decatur, IL 62521
Phone (217) 864-4494

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": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063454833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 S MOUNT ZION RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625219771",
            "telephone_number": "217-864-4494",
            "fax_number": "217-864-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 S MOUNT ZION RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625219771",
            "telephone_number": "217-864-4494",
            "fax_number": "217-864-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESEK & WILLHITE FAMILY DENTAL CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JESEK",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "217-864-4494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JESEK, WILLHITE & GRIFFIN FAMILY DENTAL CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.