Active NPI
Thomas R Nalepka, D.D.S.
- Dentist
- East Peoria, IL
National Provider Identifier
1326309188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019018403
- Practice address
- 809 W Camp St
East Peoria, IL 61611-7218 - Phone
- (309) 694-0606
- Fax
- (309) 694-0677
- NPI assigned
- Jun 7, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019018403 | IL | Primary |
Addresses
Primary practice location
809 W Camp St
East Peoria, IL 61611-7218
Mailing address
809 W Camp St
East Peoria, IL 61611-7218
Phone (309) 694-0606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019018403 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas R. Nalepka D.D.S | Past | Accepting new patients | |
| Maple Shade Dental Camp Street LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- East Peoria, IL
- NPI 1497003156
-
- General Practice Dentistry
- East Peoria, IL
- NPI 1548315575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339027200000",
"number": "1326309188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 W CAMP ST",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616117218",
"telephone_number": "309-694-0606",
"fax_number": "309-694-0677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 W CAMP ST",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616117218",
"telephone_number": "309-694-0606",
"fax_number": "309-694-0677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NALEPKA",
"first_name": "THOMAS",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-07",
"last_updated": "2012-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019018403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.