Orthodontic Associates of Columbia and Waterloo

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019025290 Issued in IL

Legal business name

ORTHODONTIC ASSOCIATES OF COLUMBIA AND WATERLOO

Practice address

1060 Admiral Weinel Blvd
Columbia, IL 62236-1988

Phone

(618) 281-3399

NPI assigned

Apr 2, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Brent Dee Bankhead, DDS, MS

Title

Dr.

Phone

(618) 281-3399

Specialties & licenses 1

Addresses

Tax ID family

Orthodontic Associates of Columbia and Waterloo2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Orthodontic Associates of Columbia and Waterloo

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Waterloo, IL
  • NPI 1952729279
  NPD tax ID

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396396800000",
    "number": "1295153641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 ADMIRAL WEINEL BLVD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361988",
            "telephone_number": "618-281-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 ADMIRAL WEINEL BLVD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361988",
            "telephone_number": "618-281-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC ASSOCIATES OF COLUMBIA AND WATERLOO",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-02",
        "last_updated": "2014-04-02",
        "status": "A",
        "authorized_official_last_name": "BANKHEAD",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "618-281-3399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019025290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Northern
• William H. Northern, DC
• Rachel Nunley, PHARM.D.
• Oa Associates LLC
• Caylie Marie Oglesby
• Orthopedic Associates, LLC
• Shanon M Osinski, A.A.S.-HIS, BC-HIS
• Tina Marie Overbey, MSW
• Cody Overmann, PHARM. D.
• Parkview Dental, LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Columbia, IL
• Providers in Columbia, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; 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.