Dale Addison Drake, DENTIST DDS

Primary specialty

DentistTaxonomy code 122300000X

Practice address

515 Pearl Street
Belvidere, IL 61008

Phone

(815) 547-8112

Fax

(815) 544-5480

NPI assigned

Mar 24, 2008

Sex

Male

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.

• DRS Drake LTD

  • Dentist
  • Belvidere, IL
  • NPI 1316007859
  NPD (past) Authorized official

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1225200892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PEARL ST",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "61008",
            "telephone_number": "815-547-8112",
            "fax_number": "815-544-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PEARL STREET",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "61008",
            "telephone_number": "815-547-8112",
            "fax_number": "815-544-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "DALE",
        "middle_name": "ADDISON",
        "credential": "DENTIST DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Brooke Dinsmore, M.S., CCC-SLP/L
• Krystal Tram DO, PHARMD
• Mohammad Ismail Dogar, D.M.D
• Donohoo Pharmacy Inc.
• Dr. James Chapko D.D.S., P.C.
• Elaine Carlson Drake, DDS
• DRS Drake LTD
• Robert Dyer, D.C.
• Megan Edge, FNP
• Hunter James Eichenberger, DPT

• Dentist in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.