Endodontics of Edwardsville PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

ENDODONTICS OF EDWARDSVILLE PLLC

Practice address

22 Glen Ed Professional Park Ste B
Glen Carbon, IL 62034-3300

Phone

(618) 659-2030

Fax

(217) 659-2035

NPI assigned

Sep 7, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Andrew James Martens, DMD, MS

Title

Owner

Phone

(309) 507-2877

Specialties & licenses 1

Addresses

Other names 1

• Signature Endodontics Doing business as

Locations

Practitioners 2

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

• Roxanne Patricia Benison, DMD MS

  • Endodontics
  • Glen Carbon, IL
  • NPI 1285651703
  NPD
• Kanika Yadav Ryan

  • Endodontics
  • Glen Carbon, IL
  • NPI 1043934433
  NPD

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1487375549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 GLEN ED PROFESSIONAL PARK STE B",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343300",
            "telephone_number": "618-659-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 GLEN ED PROFESSIONAL PARK STE B",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343300",
            "telephone_number": "618-659-2030",
            "fax_number": "217-659-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTICS OF EDWARDSVILLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "MARTENS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-507-2877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• David J Elliff, PT
• Emilee Nicole Ellingsworth
• Elise Marie Ellington, DC
• Empowerme Psychology, PLLC
• Martha Marie Engeling, ATC
• Kelli D Evans, MSRPT
• Claudia Evers, FNP-C
• Rachel Ewing
• Fairview Heights Medical Group SC

• All providers in Glen Carbon, IL
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.