NPIMap

Organization Active NPI

DRS Drake LTD

  • Dentist
  • Belvidere, IL
National Provider Identifier
1316007859
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1915991 Issued in IL
Legal business name
DRS DRAKE LTD
Practice address
515 Pearl Street
Belvidere, IL 61008
Phone
(815) 547-8112
Fax
(815) 544-5480
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dale Addison Drake, DDSNPI 1225200892
Title
President Owner
Phone
(815) 547-8112

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 1915991 IL Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 1917128 IL

Addresses

Primary practice location

515 Pearl Street
Belvidere, IL 61008

Mailing address

515 Pearl Street
Belvidere, IL 61008
Phone (815) 547-8112

National Provider Directory

National Provider Directory

Locations

515 Pearl St
Belvidere, IL 61008
Phone (815) 547-8112

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316007859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PEARL STREET",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "61008",
            "telephone_number": "815-547-8112",
            "fax_number": "815-544-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PEARL STREET",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "61008",
            "telephone_number": "815-547-8112",
            "fax_number": "815-544-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS DRAKE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "ADDISON",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "815-547-8112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "1915991",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "1917128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

  • 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.