NPIMap

Organization Active NPI

Houska Dental Center, LLC

  • Dentist
  • Bloomington, IL
National Provider Identifier
1235486762
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019020622 Issued in IL
Legal business name
HOUSKA DENTAL CENTER, LLC
Practice address
2433 Maloney Dr
Bloomington, IL 61704-3750
Phone
(309) 662-9042
NPI assigned
Aug 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Authorized official

Name
Dr. Mark HouskaNPI 1790848406
Title
Owner
Phone
(309) 662-9042

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019020622 IL Primary

Addresses

Primary practice location

2433 Maloney Dr
Bloomington, IL 61704-3750

Mailing address

2433 Maloney Dr
Bloomington, IL 61704-3750

National Provider Directory

National Provider Directory

Locations

2433 Maloney Dr
Bloomington, IL 61704
Phone (309) 662-9042

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": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1235486762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2433 MALONEY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2433 MALONEY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043750",
            "telephone_number": "309-662-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSKA DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "HOUSKA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-662-9042",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019020622",
            "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 Aug 15, 2012; 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.