Active NPI
Scott William Todd, DMD
- General Practice Dentistry
- Champaign, IL
National Provider Identifier
1407408008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019032238
- Practice address
- 303 W Springfield Ave
Champaign, IL 61820-4817 - Phone
- (217) 356-3335
- NPI assigned
- Jul 12, 2019
- Sex
- Male
- 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 | 019032238 | IL | Primary |
Addresses
Primary practice location
303 W Springfield Ave
Champaign, IL 61820-4817
Mailing address
805 Richards LN
Champaign, IL 61820-7013
Phone (309) 824-7926
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 |
|---|---|---|---|
| 019032238 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562889600000",
"number": "1407408008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 RICHARDS LN",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207013",
"telephone_number": "309-824-7926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 W SPRINGFIELD AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618204817",
"telephone_number": "217-356-3335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TODD",
"first_name": "SCOTT",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-12",
"last_updated": "2019-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019032238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.