NPIMap

Organization Active NPI

Midwest Family Dentistry PC

  • Dentist
  • Highland, IL
National Provider Identifier
1437539350
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019023663 Issued in IL
Legal business name
MIDWEST FAMILY DENTISTRY PC
Practice address
10 Apex Dr Ste 2
Highland, IL 62249-1296
Phone
(618) 654-2080
Fax
(618) 654-2090
NPI assigned
Jun 5, 2015
Last updated
Aug 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Authorized official

Name
Laney Elayne Schuman-Boys, DMD
Title
President
Phone
(618) 654-2080

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X
Dentist 122300000X 019023663 IL Primary

Addresses

Primary practice location

10 Apex Dr Ste 2
Highland, IL 62249-1296

Mailing address

10 Apex Dr Ste 2
Highland, IL 62249-1296
Phone (618) 654-2080

National Provider Directory

National Provider Directory
Tax ID family
Midwest Family Dentistry PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10 Apex Dr
Ste 2
Highland, IL 62249
Phone (618) 654-2080

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1437539350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 APEX DR STE 2",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491296",
            "telephone_number": "618-654-2080",
            "fax_number": "618-654-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 APEX DR STE 2",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491296",
            "telephone_number": "618-654-2080",
            "fax_number": "618-654-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-05",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "SCHUMAN-BOYS",
        "authorized_official_first_name": "LANEY",
        "authorized_official_middle_name": "ELAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-654-2080",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.