Michael David Danner, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019023984 Issued in IL

Practice address

1426 Valle Vista Blvd
Pekin, IL 61554-6224

Phone

(309) 346-2145

NPI assigned

May 31, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michael D. Danner, D.D.S., LLC

  • General Practice Dentistry
  • Pekin, IL
  • NPI 1568493591
  NPD (past) Authorized official

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1104110725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 VALLE VISTA BLVD",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 VALLE VISTA BLVD",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546224",
            "telephone_number": "309-346-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNER",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crossroads Programs, Inc.
• Dennis Jay Crowell, MSW, LCSW, ACSW, DCS
• Mari Teresa Cullen, BA, CADC
• Ivetta S Daccache, O.D.
• Rebekah A Dagraedt
• Char Davis, PHDH
• Debra Mollie Davis, RN BSN
• Stacey Day
• Scarlet Deluhery, LPN
• Anthony John Demonte, DSS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.