The Family Dental Center of Pinckneyville

Primary specialty

DentistTaxonomy code 122300000X

License

019019032 Issued in IL

Legal business name

THE FAMILY DENTAL CENTER OF PINCKNEYVILLE

Practice address

212 N Walnut St
Pinckneyville, IL 62274-1015

Phone

(618) 357-9333

NPI assigned

Mar 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Ray Hawkins, DMD

Title

Dentist/Owner

Phone

(618) 357-9333

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1346410156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N WALNUT ST",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741015",
            "telephone_number": "618-357-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N WALNUT ST",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741015",
            "telephone_number": "618-357-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY DENTAL CENTER OF PINCKNEYVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "618-357-9333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019019032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.