NPIMap

Organization Active NPI

Dental Professionals of Illinois, P.C.

Doing business as Sunset Hills Family Dental

  • General Practice Dentistry
  • Glen Carbon, IL
National Provider Identifier
1093937336
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Doing business as
Sunset Hills Family Dental
Practice address
87 Magnolia Dr
Glen Carbon, IL 62025-1535
Phone
(618) 692-9980
Fax
(618) 692-9905
NPI assigned
May 3, 2007
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Erika Davis
Title
Credentialing Coordinator
Phone
(217) 540-8434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

87 Magnolia Dr
Glen Carbon, IL 62025-1535

Mailing address

2 Club Centre Court
Edwardsville, IL 62025
Phone (618) 692-9980

Other names 1

  • Sunset Hills Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Family Dental Care of Illinois PC75 organizations share this tax ID, including this one
Part of
Heartland Family Dental Care of Illinois PC

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

2 Club Centre Ct
Edwardsville, IL 62025
Phone (618) 692-9980

2 Club Centre Ct
Ste 6
Edwardsville, IL 62025

87 Magnolia Dr
Glen Carbon, IL 62034
Phone (618) 692-9980

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1093937336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CLUB CENTRE COURT",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "62025",
            "telephone_number": "618-692-9980",
            "fax_number": "618-692-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 MAGNOLIA DR",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620251535",
            "telephone_number": "618-692-9980",
            "fax_number": "618-692-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF ILLINOIS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF ILLINOIS, P.C.",
        "enumeration_date": "2007-05-03",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8434"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunset Hills Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.