Riverside Dental Investments LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

RIVERSIDE DENTAL INVESTMENTS LLC

Doing business as

Generations Dental

Practice address

13510 Julie Dr
Poplar Grove, IL 61065-7829

Phone

(815) 765-9900

Fax

(815) 765-9901

NPI assigned

Jul 20, 2021

Last updated

Jul 20, 2021By 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

Sara J Bailey

Title

Office Manager

Phone

(815) 765-9900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Generations Dental 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.

• David Tartaglia, DDS

  • General Practice Dentistry
  • Poplar Grove, IL
  • NPI 1134353014
  NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1386217164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13510 JULIE DR",
            "city": "POPLAR GROVE",
            "state": "IL",
            "postal_code": "610657829",
            "telephone_number": "815-765-9900",
            "fax_number": "815-765-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13510 JULIE DR",
            "city": "POPLAR GROVE",
            "state": "IL",
            "postal_code": "610657829",
            "telephone_number": "815-765-9900",
            "fax_number": "815-765-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL INVESTMENTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "815-765-9900"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1134353014",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1356461255",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Generations Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Poplar Grove Natural Health Center Inc
• Poplar Grove Natural Health Center SC
• Poplar Grove Physical Therapy, Inc. (CORA Physical Therapy - Poplar Grove)
• Sherry Ramos, LCPC
• Rehab Care
• Joseph M Rocuskie, ATC
• Ryan Sheltered Care LLC
• Andrew Schwenk, DDS
• Taylor Siracusa
• Tila Smith, LPN

• Clinic/Center in Poplar Grove, IL
• Providers in Poplar Grove, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.