NPIMap

Organization Active NPI

Affordable Dentistry Today, PC

Doing business as Affordable Dentistry Today - Bloomington

  • General Practice Dentistry
  • Bloomington, IL
National Provider Identifier
1205058666
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AFFORDABLE DENTISTRY TODAY, PC
Doing business as
Affordable Dentistry Today - Bloomington
Affordable Dentistry Today - Veterans Parkway
Practice address
1507 North Veterans Parkway
Suite 2
Bloomington, IL 61704
Phone
(309) 664-5033
Fax
(309) 663-0967
NPI assigned
May 3, 2007
Last updated
Nov 2, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
AFFORDABLE DENTISTRY TODAY, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1507 North Veterans Parkway
Suite 2
Bloomington, IL 61704

Mailing address

1507 North Veterans Parkway
Suite 2
Bloomington, IL 61704
Phone (309) 664-5033

Other names 2

  • Affordable Dentistry Today - Bloomington Doing business as
  • Affordable Dentistry Today - Veterans Parkway Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Affordable Dentistry Today PC13 organizations share this tax ID, including this one
Part of
Affordable Dentistry Today PC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1507 N Veterans Pkwy
Ste 2
Bloomington, IL 61704
Phone (309) 661-0197

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1205058666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 NORTH VETERANS PARKWAY",
            "address_2": "SUITE 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-664-5033",
            "fax_number": "309-663-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 NORTH VETERANS PARKWAY",
            "address_2": "SUITE 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-664-5033",
            "fax_number": "309-663-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTISTRY TODAY, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AFFORDABLE DENTISTRY TODAY, PC",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dentistry Today - Bloomington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Affordable Dentistry Today - Veterans Parkway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.