Smalltown Dental Chillicothe LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMALLTOWN DENTAL CHILLICOTHE LLC

Practice address

1008 N 4TH St Ste B
Chillicothe, IL 61523-1574

Phone

(309) 274-3820

NPI assigned

Jan 3, 2022

Last updated

Jan 3, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

SMALLTOWN DENTAL MANAGEMENT LLCAs reported in NPPES

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

Authorized official

Name

Luke Overcash

Title

Cio

Phone

(309) 370-5853

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1477214484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17471 MOORE RD",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615509222",
            "telephone_number": "309-370-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N 4TH ST STE B",
            "city": "CHILLICOTHE",
            "state": "IL",
            "postal_code": "615231574",
            "telephone_number": "309-274-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALLTOWN DENTAL CHILLICOTHE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMALLTOWN DENTAL MANAGEMENT LLC",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "OVERCASH",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "309-370-5853"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Ryan Riech, M.D., MPH
• Carlos Juan Roa
• Daniel C Routh, PT
• Bradley Rummel
• Brian A Schrock, PA
• Sean B Smith, O.T
• Hallie Sperry, RN
• Maureen J Sylvester, P. T.
• T. J. Freund DDS, P.C. (Chillicothe Dental Center)
• Amber Lynne Tucker-Fishel, LPTA

• General Practice Dentistry in Chillicothe, IL
• Providers in Chillicothe, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.