Darren A. Altadonna, DMD, FAGD
Individual provider Active NPI General Practice Dentistry · Highland, IL
NPI 1104994094 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104994094
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 1117 Washington Street
Highland, IL 62249-1922 - Phone
- (618) 654-9866
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019023974 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barker & Barker, P.C. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
1117 Washington Street
Highland, IL 62249-1922
Mailing address
1117 Washington Street
Highland, IL 62249-1922
Other providers in Highland, IL
- 3 Arrows Pediatric Therapy, LLC
- 3F Vision LLC
- Hartley Abner
- Adult Medicine of Highland, LTD
- Cameron Anthony Altadonna
- Alvarado Healthcare LLC
- Alejandro J Alvarado
- Janet L Alvarado
- Marcus Daniel Alvarado
- American Medical Equipment Inc
All providers in Highland, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.