Rita M Demask, RDH, PHDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

020.006993 Issued in IL

Practice address

1177 Rentsch Dr
East Peoria, IL 61611-5429

Phone

(309) 369-3586

NPI assigned

Jul 17, 2023

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1275212391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 RENTSCH DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616115429",
            "telephone_number": "309-369-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 RENTSCH DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616115429",
            "telephone_number": "309-369-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMASK",
        "first_name": "RITA",
        "middle_name": "M",
        "credential": "RDH, PHDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020.006993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Professionals of Illinois, P.C. (Family Dental Care of East Peoria)
• Rachel Derickson
• Samantha Despines, PHARMD
• Ann Devore
• Dialysis Centers of America - Illinois, Inc. (RCG Central Illinois-East Peoria)

• Dental Hygienist in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Dental Hygienist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.