Active NPI
Heather Surratt, D.D.S.
- General Practice Dentistry
- Centreville, IL
National Provider Identifier
1386633295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19-026518
- Practice address
- 6000 Bond Ave
Sihf - MCC
Centreville, IL 62207-2328 - Phone
- (618) 332-2740
- Fax
- (618) 332-8755
- NPI assigned
- Oct 14, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19-026518 | IL | Primary |
Addresses
Primary practice location
6000 Bond Ave
Sihf - MCC
Centreville, IL 62207-2328
Mailing address
1160 Tazewell Dr
O Fallon, IL 62269-7149
Phone (618) 632-5090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19-026518 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1386633295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1160 TAZEWELL DR",
"city": "O FALLON",
"state": "IL",
"postal_code": "622697149",
"telephone_number": "618-632-5090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 BOND AVE",
"address_2": "SIHF - MCC",
"city": "CENTREVILLE",
"state": "IL",
"postal_code": "622072328",
"telephone_number": "618-332-2740",
"fax_number": "618-332-8755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURRATT",
"first_name": "HEATHER",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "19-026518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centreville, IL
- Southern Illinois Healthcare Foundation, Inc (Touchette Health Center)
- Southern Illinois Healthcare Foundation, Inc. (SIHF Healthcare)
- Amanda Michele Stahnke, PHARMD
- Birgit Sterzl, DIETICIAN
- Bonnie J Summers, NP
- Diana L Swanson, MSN, APRN, WHNP-BC
- Jami Szwargulski, RD, LD
- Tyler D Thurman, LCPC
- Transitional Center Inc.
- Danielle Victoria Williams, RD, LDN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.