Prairie View Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PRAIRIE VIEW DENTAL LLC

Practice address

115 W Peace Rd
Sycamore, IL 60178

Phone

(815) 895-6100

Fax

(815) 895-6107

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Tiffany K JozwiakNPI 1902068026

Title

Dentist Owner

Phone

(815) 895-6100

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Tiffany Koerner Jozwiak, DDS

  • Dentist
  • Sycamore, IL
  • NPI 1902068026
  NPD (past) Authorized official
• Jeff Yasin Lu, DDS

  • Dentist
  • Sycamore, IL
  • NPI 1881762581
  NPD (past)
• Jennifer Williams, D.D.S.

  • General Practice Dentistry
  • Sycamore, IL
  • NPI 1457614166
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063570752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W PEACE RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-895-6100",
            "fax_number": "815-895-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W PEACE RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-895-6100",
            "fax_number": "815-895-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE VIEW DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOZWIAK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "815-895-6100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda R Pollnow, AT-C
• Odolina Calderon Pope, FNP-C
• Heather C. Porter, M.A. CCC-SLP
• Prairie Health Care, LTD
• Prairie Point Obstetrics and Gynecology LTD
• Patrice A Pritchard, RN
• Proactive Chiropractic & Laser Center, LLC
• Professional Services for Anxiety-Related Disorders, LLC
• Professional Services in Health Psychology, LTD
• Sara Louise Quincer, MA, LCPC

• Dentist in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Dentist in Illinois

• 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.