NPIMap

Organization Active NPI

Pinckneyville Dental Care

  • Dental Clinic/Center
  • Pinckneyville, IL
National Provider Identifier
1104939735
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
19020196 Issued in IL
Legal business name
PINCKNEYVILLE DENTAL CARE
Practice address
1000 S Main St
Pinckneyville, IL 62274-1772
Phone
(618) 357-2445
Fax
(618) 357-9549
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Authorized official

Name
Dr. Ralph Kane Chapman, DMD
Title
Owner
Phone
(618) 357-2445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 19020196 IL Primary

Addresses

Primary practice location

1000 S Main St
Pinckneyville, IL 62274-1772

Mailing address

PO Box 469
Pinckneyville, IL 62274-0469
Phone (618) 357-2445

National Provider Directory

National Provider Directory

Locations

1000 S Main St
Pinckneyville, IL 62274
Phone (618) 357-2445

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406678400000",
    "number": "1104939735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 469",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622740469",
            "telephone_number": "618-357-2445",
            "fax_number": "618-357-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S MAIN ST",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741772",
            "telephone_number": "618-357-2445",
            "fax_number": "618-357-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINCKNEYVILLE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2014-07-30",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "KANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-357-2445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "19020196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinckneyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.