Organization Active NPI

Dental Group of Galesburg PLLC

  • General Practice Dentistry
  • Galesburg, IL
National Provider Identifier
1225683766
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL GROUP OF GALESBURG PLLC
Practice address
1865 N Henderson St Ste 9
Galesburg, IL 61401-1377
Phone
(270) 556-4342
NPI assigned
Aug 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Dr. Cody Krech, DMDNPI 1538468210
Title
Owner/Manager
Phone
(270) 556-4342

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1865 N Henderson St Ste 9
Galesburg, IL 61401-1377

Mailing address

1865 N Henderson St Ste 9
Galesburg, IL 61401-1377
Phone (309) 342-4144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260109000221 IL DME Supplier - Oral Surgery - Dentist 8123504115 Practice locations: Galesburg, IL

National Provider Directory

National Provider Directory

Locations

1865 N Henderson St
Ste 9
Galesburg, IL 61401
Phone (270) 556-4342

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1225683766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 N HENDERSON ST STE 9",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011377",
            "telephone_number": "309-342-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 N HENDERSON ST STE 9",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011377",
            "telephone_number": "270-556-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL GROUP OF GALESBURG PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-01",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "KRECH",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "270-556-4342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.