Lincolnway Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LINCOLNWAY DENTAL LLC

Practice address

2501 E Lincolnway Unit 3
Sterling, IL 61081-3055

Phone

(815) 275-2680

NPI assigned

Jun 10, 2024

Organization subpart

Yes

Parent organization

DR SCOTT BARESAs reported in NPPES

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

Authorized official

Name

Dr. Scott Bares, DDS

Title

President

Phone

(815) 275-2680

Specialties & licenses 1

Addresses

Part of

Lincolnway Dental LLC

Locations

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1104668391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 S HARLEM AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326231",
            "telephone_number": "815-275-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E LINCOLNWAY UNIT 3",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610813055",
            "telephone_number": "815-275-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLNWAY DENTAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR SCOTT BARES",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "BARES",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-275-2680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Sterling, IL
• Providers in Sterling, 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 Jun 10, 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.