Individual provider Active NPI

Sarah L Swanlund, DMD

  • Dentist
  • Bloomington, IL
National Provider Identifier
1477815157
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.029030 Issued in IL
Practice address
143 N Williamsburg Dr
Bloomington, IL 61704-3528
Phone
(309) 661-1500
NPI assigned
Jun 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.029030 IL Primary

Addresses

Primary practice location

143 N Williamsburg Dr
Bloomington, IL 61704-3528

Mailing address

143 N Williamsburg Dr
Bloomington, IL 61704-3528
Phone (309) 661-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150528002812 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0345560579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.029030ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah L. Swanlund, DMD, Inc. CurrentSince Feb 6, 2022 Accepting new patients

Locations

143 N Williamsburg Dr
Bloomington, IL 61704
Phone (309) 661-1500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1477815157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 N WILLIAMSBURG DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043528",
            "telephone_number": "309-661-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 N WILLIAMSBURG DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043528",
            "telephone_number": "309-661-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANLUND",
        "first_name": "SARAH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.029030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.