Marcin Dental Centers PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019013646 Issued in IL

Legal business name

MARCIN DENTAL CENTERS PC

Practice address

7620 N University
Peoria, IL 61614

Phone

(309) 693-0043

Fax

(309) 693-0422

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Roseanne Brunenkant

Title

Office Manager

Phone

(309) 274-6237

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1366502825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 N UNIVERSITY",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-693-0043",
            "fax_number": "309-693-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 N UNIVERSITY",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-693-0043",
            "fax_number": "309-693-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIN DENTAL CENTERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "BRUNENKANT",
        "authorized_official_first_name": "ROSEANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "309-274-6237",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019013646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryah Mansoor, MD
• Sarah Manzoor, MD
• Claire Abbott Maquet, LCPC
• Lucy F Marcello
• Elisa Ann Marchand, PTA
• Johnnatan Marin, MD
• Mark K Werking, DC, SC
• Tracie M Markey, APN
• Teresa Ann Marksity-Leach, LCSW
• Rafael Marquez, MD

• General Practice Dentistry in Peoria, IL
• Providers in Peoria, 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 Apr 26, 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.

Verify at the official NPI Registry.