NPIMap

Organization Active NPI

Heartland Family Dental Care of Illinois, PC

  • General Practice Dentistry
  • Charleston, IL
National Provider Identifier
1245443514
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HEARTLAND FAMILY DENTAL CARE OF ILLINOIS, PC
Doing business as
Coles County Family Dental Care
Practice address
826 W Lincoln
Suite B
Charleston, IL 61920
Phone
(217) 345-5250
Fax
(217) 345-5390
NPI assigned
May 7, 2007
Organization subpart
Yes
Parent organization
HEARTLAND FAMILY DENTAL CARE OF ILLINOIS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Amy Kroeger
Title
Ins Cood
Phone
(217) 540-5100

Specialties & licenses 1

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

Addresses

Primary practice location

826 W Lincoln
Suite B
Charleston, IL 61920

Mailing address

826 W Lincoln
Suite B
Charleston, IL 61920
Phone (217) 345-5250

Other names 1

  • Coles County Family Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Illinois PC75 organizations share this tax ID, including this one
Part of
Dental Professionals of Illinois PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

826 W Lincoln Ave
Ste B
Charleston, IL 61920
Phone (217) 345-5250

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1245443514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 W LINCOLN",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-345-5250",
            "fax_number": "217-345-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 W LINCOLN",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-345-5250",
            "fax_number": "217-345-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND FAMILY DENTAL CARE OF ILLINOIS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND FAMILY DENTAL CARE OF ILLINOIS, PC",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "KROEGER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "INS COOD",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coles County Family Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.