Dawn A Jackson-Breeden, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

405 E Park St
Benton, IL 62812-1971

Phone

(618) 439-4391

Fax

(618) 439-7410

NPI assigned

Nov 29, 2006

Sex

Female

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Dawn a Jackson-Breeden DMD LTD

  • General Practice Dentistry
  • Benton, IL
  • NPI 1649492059
  NPD (past) Authorized official

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245307024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E PARK ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121971",
            "telephone_number": "618-439-4391",
            "fax_number": "618-439-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E PARK ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121971",
            "telephone_number": "618-439-4391",
            "fax_number": "618-439-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-BREEDEN",
        "first_name": "DAWN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Highland Park CVS, L.L.C.
• Samantha Hilmers, MSW, LCSW
• Robert Loren Hitt, CRNA, APN
• Lovelia Cabrera Horn, PT
• Brooke Hudson, FNP
• John T Hall M.D.
• Kathalynas Spine, Sport & Rehabilitation LLC
• Allyson Lynne Kathalynas, D. C.
• Ryan Kathalynas, DC
• Ashley S Kaytor-McCoy, MD

• General Practice Dentistry in Benton, IL
• Providers in Benton, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.