Alex McCoy Daniel, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.032375 Issued in IL

Practice address

6215 E State St
Rockford, IL 61108-2514

Phone

(815) 399-7777

NPI assigned

Jul 30, 2019

Last updated

Sep 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Dental Experts, LLC

  • General Practice Dentistry
  • Rockford, IL
  • NPI 1437320421
  NPD (past)

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1578117339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 HAMPSTEAD DR",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605542206",
            "telephone_number": "630-608-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082514",
            "telephone_number": "815-399-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "ALEX",
        "middle_name": "MCCOY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032375",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dana
• Richard Wayne Dana I
• Thomas J Danaher, MD
• Daniel & Max, LLC (Stanton Optical)
• Daniel H Pham, LLC.
• Thomas Allen Daniels, D.D.S.
• Thomas Danko, MD
• Jessica Dannenmaier, PSY,D.
• William C Dannenmaier, MD
• David J Dansdill, M.D.

• Dentist in Rockford, IL
• Providers in Rockford, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.