Restoration Dental LLC- Marshall Dental Professionals

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RESTORATION DENTAL LLC- MARSHALL DENTAL PROFESSIONALS

Doing business as

Marshall Dental Professionals

Practice address

815 N 2ND St
Marshall, IL 62441-1086

Phone

(217) 826-5181

Fax

(217) 826-2651

NPI assigned

Feb 16, 2012

Last updated

Oct 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jamie Vilk

Title

Operations Manager

Phone

(217) 348-7770

Specialties & licenses 1

Addresses

Other names 1

• Marshall Dental Professionals Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tabitha Hanson, DMD

  • Dentist
  • Marshall, IL
  • NPI 1356073993
  NPD (past)

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1326311630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 18TH ST.",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-348-7770",
            "fax_number": "217-349-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N 2ND ST",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411086",
            "telephone_number": "217-826-5181",
            "fax_number": "217-826-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION DENTAL LLC- MARSHALL DENTAL PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "VILK",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "217-348-7770"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marshall Dental Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly Newkirk, PTA
• Marilyn Sue Patton, LMT
• Bret Tibay Pelesco, PT, DPT
• Denise Pine-Mattas, MD
• Gayle Rayhel
• Rhoads to Healthy LLC
• Selah Partners, LLC
• SGM Physical Therapy
• Shore-Murphy and Associates, LLC
• Sadie Belle Siddons, OTR/L

• General Practice Dentistry in Marshall, IL
• Providers in Marshall, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.