Abdul L Junidi, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

1035 E Jonas St
Centralia, IL 62801-3309

Phone

(618) 533-6709

Fax

(618) 545-1047

NPI assigned

Jan 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396894093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 E. JONAS AVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "62801",
            "telephone_number": "618-533-6709",
            "fax_number": "618-545-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 E JONAS ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013309",
            "telephone_number": "618-533-6709",
            "fax_number": "618-545-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNIDI",
        "first_name": "ABDUL",
        "middle_name": "L",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2004026472",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Johnson, LCPC
• Laura Marie Johnson, DPT
• Rae A Johnson
• Robin Lee Johnson, OD
• Virginia Lee Jones, CSADC
• Maamoun A Junidi, MD
• Melissa Karaffa, APN
• Kaskaskia Special Ed Dist
• Kaskaskia Workshop, Inc.
• Kaskaskia Workshop, Inc.

• General Practice Dentistry in Centralia, IL
• Providers in Centralia, 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 Jul 8, 2007; 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.