Rockford Dental Associates

Primary specialty

DentistTaxonomy code 122300000X

License

019026768 Issued in IL

Legal business name

ROCKFORD DENTAL ASSOCIATES

Practice address

8100 Forest Hills Rd
Loves Park, IL 61111-2709

Phone

(815) 633-9864

Fax

(815) 327-9160

NPI assigned

Oct 28, 2015

Last updated

Oct 28, 2015By 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

Dr. David Dimke, DMD

Title

Dentist

Phone

(815) 519-6218

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1407228513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6078 PALO VERDE DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148117",
            "telephone_number": "815-633-9864",
            "fax_number": "815-327-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 FOREST HILLS RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112709",
            "telephone_number": "815-633-9864",
            "fax_number": "815-327-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKFORD DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "DIMKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "815-519-6218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside Dental Center
• Riverside Dental Center GPS PLLC (Riverside Dental Center)
• Rock Valley Advanced Pain Management Inc.
• Rockford Anesthesiologists Associated, L.L.C.
• Rockford Anesthesiologists Associated, L.L.C.
• Rockford Eye & Laser Center LTD.
• Rockford Health Physicians (Mercyhealth Orthopedic Clinic)
• Rockford Pain & Rehab, LLC
• Amanda L Roettger, RN,BSN
• Jonathan David Rohl, D.D.S.

• Dentist in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.