Affordable Dentistry of Il LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

319017393 Issued in IL

Legal business name

AFFORDABLE DENTISTRY OF IL LLC

Practice address

195 S Main St
Dupo, IL 62239-1347

Phone

(618) 286-4400

NPI assigned

Jul 27, 2010

Last updated

Jul 27, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Matthew Stegmann

Title

Dentist/Owner

Phone

(618) 286-4400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1487968814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 S MAIN ST",
            "city": "DUPO",
            "state": "IL",
            "postal_code": "622391347",
            "telephone_number": "618-286-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 S MAIN ST",
            "city": "DUPO",
            "state": "IL",
            "postal_code": "622391347",
            "telephone_number": "618-286-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTISTRY OF IL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "STEGMANN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "618-286-4400"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "319017393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcel Acris, DDS
• Affordable Dental of Illinois
• Allison Benware
• Michael Z Bialas, D.C.
• Jenna Bivens
• Community Unit School District No 196
• Michael Robert Dambacher, PTA

• General Practice Dentistry in Dupo, IL
• Providers in Dupo, 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 Jul 27, 2010; 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.