Herrin Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HERRIN DENTAL LLC

Doing business as

Weekend Dental

Practice address

3024 S Park Ave
Herrin, IL 62948-3721

Phone

(833) 337-9563

NPI assigned

Aug 1, 2022

Last updated

Sep 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mahmoud Jallad, DDSNPI 1083013171

Title

Owner Dentist

Phone

(334) 354-7852

Specialties & licenses 1

Addresses

Other names 1

• Weekend Dental Doing business as

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.

• Mahmoud Jallad, DDS, MSD

  • Dentist
  • Herrin, IL
  • NPI 1083013171
  NPD Authorized official

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662163200000",
    "number": "1275260218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 ARABIAN CT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483788",
            "telephone_number": "334-354-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483721",
            "telephone_number": "833-337-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERRIN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A",
        "authorized_official_last_name": "JALLAD",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "334-354-7852",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weekend Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luke Thomas Hentrich
• Alyissa D Hentz
• Herrin Clinic LTD
• Herrin Community Unit Dist 4
• Herrin Community Unit School District No 4
• Herrin Drug Inc
• Herrin Drug Inc (Herrin Drug)
• Herrin Hospital Pharmacy
• Herrin Pediatrics
• Herrin Rehabilitation and Nursing Center, LLC

• Dental Clinic/Center in Herrin, IL
• Providers in Herrin, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; 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.