NPIMap

Organization Active NPI

Goebel Family Dentistry, LLC

  • General Practice Dentistry
  • Moline, IL
National Provider Identifier
1295077394
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019029257 Issued in IL
Legal business name
GOEBEL FAMILY DENTISTRY, LLC
Practice address
1601 River Dr
Suite 300
Moline, IL 61265-1494
Phone
(309) 277-3480
Fax
(309) 277-3499
NPI assigned
Mar 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Dr. Thomas James Goebel, D.D.S.NPI 1164774766
Title
Owner/Dentist
Phone
(309) 277-3480

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 019029257 IL Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 019018218 IL

Addresses

Primary practice location

1601 River Dr
Suite 300
Moline, IL 61265-1494

Mailing address

1601 River Dr
Suite 300
Moline, IL 61265-1494
Phone (309) 277-3480

Other names 1

  • Goebel Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1601 River Dr
Ste 300
Moline, IL 61265
Phone (309) 237-0272

Practitioners & affiliated clinicians

Practitioners 2

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": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1295077394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 RIVER DR",
            "address_2": "SUITE 300",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651494",
            "telephone_number": "309-277-3480",
            "fax_number": "309-277-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 RIVER DR",
            "address_2": "SUITE 300",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651494",
            "telephone_number": "309-277-3480",
            "fax_number": "309-277-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOEBEL FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "GOEBEL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "309-277-3480",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029257",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019018218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goebel Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.