NPIMap

Organization Active NPI

Buskirk & Haarman

  • General Practice Dentistry
  • Decatur, IL
National Provider Identifier
1447847843
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BUSKIRK & HAARMAN
Doing business as
Central Illinois Smiles
Practice address
3250 N Woodford St
Decatur, IL 62526-2836
Phone
(217) 877-1742
NPI assigned
Dec 31, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Mary Katherine Booth, DDSNPI 1629205554
Title
Owner /Dentist
Phone
(217) 877-1742

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3250 N Woodford St
Decatur, IL 62526-2836

Mailing address

3250 N Woodford St
Decatur, IL 62526-2836
Phone (217) 877-1742

Other practice location 1

400 W Main Cross St
Taylorville, IL 62568-2156
Phone (217) 824-8232

Other names 1

  • Central Illinois Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

400 W Main Cross St
Taylorville, IL 62568
Phone (217) 824-8232

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1447847843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 N WOODFORD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262836",
            "telephone_number": "217-877-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 N WOODFORD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262836",
            "telephone_number": "217-877-1742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W Main Cross St",
            "address_purpose": "LOCATION",
            "city": "Taylorville",
            "state": "IL",
            "postal_code": "625682156",
            "country_code": "US",
            "telephone_number": "217-824-8232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BUSKIRK & HAARMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-31",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER /DENTIST",
        "authorized_official_telephone_number": "217-877-1742",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Illinois Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Illinois Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.