Thomas Alan Daniels, DDS
Individual provider Active NPI General Practice Dentistry · Geneseo, IL
NPI 1487871356 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487871356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 216 S Center St
Geneseo, IL 61254-1402 - Phone
- (309) 944-6125
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-021115 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
216 S Center St
Geneseo, IL 61254-1402
Mailing address
13341 N 2150TH Ave
Geneseo, IL 61254-9117
Phone (309) 944-3262
Other providers in Geneseo, IL
- Linda T Claeys
- Jill Clong
- Mylee Cole
- Brittany Courson
- Seth Thomas Daniels
- Amy Kristine Darwin
- Allison Jo David
- Andrea Davis
- Morrie Martin Deporter
- Kate Dibbin
All providers in Geneseo, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.