Midwest Orthodontic Associates

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

MIDWEST ORTHODONTIC ASSOCIATES

Practice address

5006 N University St
Peoria, IL 61614-4715

Phone

(309) 691-9665

Fax

(309) 691-9665

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Stephen C Roehm, D.D.S, M.S.NPI 1902058985

Title

President

Phone

(309) 691-9665

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen C Roehm, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Peoria, IL
  • NPI 1902058985

  Orthodontics and Dentofacial Orthopedics

  NPD (past) Authorized official
• Melissa K Roehm-Stigall, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Peoria, IL
  • NPI 1760695225

  Orthodontics and Dentofacial Orthopedics

  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306988092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144715",
            "telephone_number": "309-691-9665",
            "fax_number": "309-691-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144715",
            "telephone_number": "309-691-9665",
            "fax_number": "309-691-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ORTHODONTIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROEHM",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-9665",
        "authorized_official_credential": "D.D.S, M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004551",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Ear Nose & Throat Associates S.C.
• Midwest Eye Care PC
• Midwest Family Medical PC
• Midwest Hearing Center
• Midwest Multicare, PC
• Midwest Orthopaedic Center S C
• Midwest Pain & Spine Center, LLC
• Midwest Podiatry Group, PC
• Midwest Reproductive Care LLC
• Midwest Urological Group, LTD.

• All providers in Peoria, IL
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.