Periodontics of Rockford LTD.

Primary specialty

DentistTaxonomy code 122300000X

License

021002217 Issued in IL

Legal business name

PERIODONTICS OF ROCKFORD LTD.

Practice address

1055 Featherstone Rd
Rockford, IL 61107

Phone

(815) 227-5858

Fax

(815) 227-6238

NPI assigned

Oct 30, 2008

Organization subpart

Yes

Parent organization

PERIODONTICS OF ROCKFORD LTD.As reported in NPPES

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

Authorized official

Name

Jeffrey V.a. Burch, D.M.D., M.S.

Title

Periodontist

Phone

(815) 227-5858

Specialties & licenses 1

Addresses

Part of

Periodontics of Rockfor

Locations

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225324800000",
    "number": "1295988574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 FEATHERSTONE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61107",
            "telephone_number": "815-227-5858",
            "fax_number": "815-227-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 FEATHERSTONE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61107",
            "telephone_number": "815-227-5858",
            "fax_number": "815-227-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTICS OF ROCKFORD LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERIODONTICS OF ROCKFORD LTD.",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-10-30",
        "status": "A",
        "authorized_official_last_name": "BURCH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "V.A.",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "815-227-5858",
        "authorized_official_credential": "D.M.D., M.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "021002217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray Peregrino, DPT
• Jude Perez, M.D.
• Laura Perez, CNM, APRN
• Rolando Perez, IMG, LSA
• Kacy Perfors, OTR
• Kami Rae Perkins, PTA
• Michelle Marie Perleberg, PTA
• Molly Macinnes Perri, MD
• Margaret S Perrin, LMT
• Matteo Perrone, MD

• Dentist in Rockford, IL
• Providers in Rockford, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.