Organization Active NPI

32 Cottage Dental LLC

  • General Practice Dentistry
  • Bloomington, IL
National Provider Identifier
1225910607
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
32 COTTAGE DENTAL LLC
Practice address
2206 Cottage Ave
Bloomington, IL 61701-1447
Phone
(309) 228-9573
NPI assigned
Jul 24, 2025
Last updated
May 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Samantha Hernandez
Title
RCM Credentialing Manager
Phone
(331) 645-5299

Specialties & licenses 1

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

Addresses

Primary practice location

2206 Cottage Ave
Bloomington, IL 61701-1447

Mailing address

2206 Cottage Ave
Bloomington, IL 61701-1447
Phone (309) 828-1463

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1753315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1225910607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 COTTAGE AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011447",
            "telephone_number": "309-828-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 COTTAGE AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011447",
            "telephone_number": "309-228-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "32 COTTAGE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-24",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "RCM CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "331-645-5299"
    },
    "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 Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.