Stacey Karzen Van Scoyoc, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

908 N Hershey Rd
Suite 2
Bloomington, IL 61704-3730

Phone

(309) 664-0570

NPI assigned

May 20, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Bloomington Family Dental, LTD.

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1467674770
  NPD (past)

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194933283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 N HERSHEY RD",
            "address_2": "SUITE 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043730",
            "telephone_number": "309-664-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N HERSHEY RD",
            "address_2": "SUITE 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043730",
            "telephone_number": "309-664-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SCOYOC",
        "first_name": "STACEY",
        "middle_name": "KARZEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Wintersteen Valdes, PT
• Tara Valentine
• Ricardo Vallejo, MD
• Van Aman Center for Wellness, PLLC
• Tana Van Meter, PT,DPT
• Tracy L Vanapeldoorn, APRN, FNP-C
• David Arlen Vancoppenolle, P.T.
• William K. Vanderwaal, D.D.S.
• Jessica N Vanderway, M.S. CF-SLP
• Jesse L Vanle, M.D.

• General Practice Dentistry in Bloomington, IL
• Providers in Bloomington, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.