NPIMap

Organization Active NPI

Morton Dental Center

  • General Practice Dentistry
  • Morton, IL
National Provider Identifier
1487875878
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MORTON DENTAL CENTER
Practice address
1600 S 4TH Ave
Ste 110
Morton, IL 61550-2889
Phone
(309) 263-2781
Fax
(309) 263-4161
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Erika K Grimm, D.D.S.
Title
V. Pres.
Phone
(309) 263-2781

Specialties & licenses 1

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

Addresses

Primary practice location

1600 S 4TH Ave
Ste 110
Morton, IL 61550-2889

Mailing address

1600 S 4TH Ave
Ste 110
Morton, IL 61550-2889
Phone (309) 263-2781

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487875878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 4TH AVE",
            "address_2": "STE 110",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502889",
            "telephone_number": "309-263-2781",
            "fax_number": "309-263-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 4TH AVE",
            "address_2": "STE 110",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502889",
            "telephone_number": "309-263-2781",
            "fax_number": "309-263-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTON DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "V. PRES.",
        "authorized_official_telephone_number": "309-263-2781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.