NPIMap

Organization Active NPI

Kids First Dental Group

  • General Practice Dentistry
  • Peoria, IL
National Provider Identifier
1609141464
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KIDS FIRST DENTAL GROUP
Practice address
7314 N Willow Lake CT Ste D
Peoria, IL 61614-8289
Phone
(309) 692-0175
Fax
(309) 692-3139
NPI assigned
Mar 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Dr. Laura Donlan, DDSNPI 1821326190
Title
Owner
Phone
(309) 692-0175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X

Addresses

Primary practice location

7314 N Willow Lake CT Ste D
Peoria, IL 61614-8289

Mailing address

7314 N Willow Lake CT Ste D
Peoria, IL 61614-8289
Phone (309) 692-0175

National Provider Directory

National Provider Directory
Tax ID family
Kids First Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1609141464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7314 N WILLOW LAKE CT STE D",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148289",
            "telephone_number": "309-692-0175",
            "fax_number": "309-692-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7314 N WILLOW LAKE CT STE D",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148289",
            "telephone_number": "309-692-0175",
            "fax_number": "309-692-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS FIRST DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "DONLAN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-692-0175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.