Jerseyville Dental Group LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

JERSEYVILLE DENTAL GROUP LLC

Practice address

105 S State St
Jerseyville, IL 62052-1850

Phone

(618) 498-5822

Fax

(618) 498-5822

NPI assigned

Jan 3, 2024

Organization subpart

No

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

Authorized official

Name

Diana Lifritz

Title

Director of Operations/Acquisitions

Phone

(618) 873-7500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1386414290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S STATE ST",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620521850",
            "telephone_number": "618-498-5822",
            "fax_number": "618-498-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S STATE ST",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620521850",
            "telephone_number": "618-498-5822",
            "fax_number": "618-498-5822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 S Washington St",
            "address_purpose": "LOCATION",
            "city": "Jerseyville",
            "state": "IL",
            "postal_code": "620521672",
            "country_code": "US",
            "telephone_number": "618-498-3621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JERSEYVILLE DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "LIFRITZ",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS/ACQUISITIONS",
        "authorized_official_telephone_number": "618-873-7500"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jersey County Anesthesia Group LTD
• Jersey County Health Department
• Jersey County Health Department
• Jersey Family Vision Care, LTD
• Jerseyville Chiropractic and Rehab LLC (Williams Chiropractic)
• Jerseyville Estates
• Trent Jilg
• Julia D Joellenbeck, BEHAVIOR TECHNICIAN
• Callie Johnson, LPC
• Jessica Johnson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.