Individual provider Active NPI

Denise R Flynn, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pekin, IL
National Provider Identifier
1194817080
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Practice address
600 S 4TH St
Pekin, IL 61554-4570
Phone
(309) 346-5140
Fax
(309) 346-1847
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X IL Primary

Addresses

Primary practice location

600 S 4TH St
Pekin, IL 61554-4570

Mailing address

600 S 4TH St
Pekin, IL 61554-4570
Phone (309) 346-5140

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250812002567 IL Practitioner - Dentist 4385965599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
021-001854ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Jul 1, 2025 Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2025 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Denise R. Flynn DDS LTD Orthodontics and Dentofacial Orthopedics PastSince May 18, 2025 Accepting new patients
Denise R. Flynn DDS LTD Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Locations

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194817080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S 4TH ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544570",
            "telephone_number": "309-346-5140",
            "fax_number": "309-346-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S 4TH ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544570",
            "telephone_number": "309-346-5140",
            "fax_number": "309-346-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "DENISE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

Verify at the official NPI Registry.