Individual provider Active NPI

Grace Dane, RDH, PHDH

  • Dental Hygienist
  • Champaign, IL
National Provider Identifier
1417820531
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
020.016580 Issued in IL
Practice address
201 W Kenyon Rd
Champaign, IL 61820-7892
Phone
(217) 531-4279
NPI assigned
Sep 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 020.016580 IL Primary

Addresses

Primary practice location

201 W Kenyon Rd
Champaign, IL 61820-7892

Mailing address

803 E Fairview Dr
Tuscola, IL 61953-2002
Phone (217) 531-4279

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

LicenseStateTypeSpecialty
020.016580ILMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1417820531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 E FAIRVIEW DR",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "619532002",
            "telephone_number": "217-531-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W KENYON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207892",
            "telephone_number": "217-531-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANE",
        "first_name": "GRACE",
        "credential": "RDH, PHDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020.016580",
            "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 Sep 25, 2025; 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.