Southern Il Dental Sleep Medicine

Primary specialty

DentistTaxonomy code 122300000X

License

060.011093 Issued in IL

Legal business name

SOUTHERN IL DENTAL SLEEP MEDICINE

Practice address

864 Koonce Rd
Murphysboro, IL 62966-6048

Phone

(618) 529-2471

Fax

(618) 529-2482

NPI assigned

Nov 5, 2013

Last updated

Nov 5, 2013By 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

Michael R Durr, DMDNPI 1417060674

Title

Owner

Phone

(618) 529-2471

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Robert Durr, D.M.D.

  • General Practice Dentistry
  • Carbondale, IL
  • NPI 1417060674
  Authorized official Same address or phone

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1629407119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 KOONCE RD",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629666048",
            "telephone_number": "618-529-2471",
            "fax_number": "618-529-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 KOONCE RD",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629666048",
            "telephone_number": "618-529-2471",
            "fax_number": "618-529-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN IL DENTAL SLEEP MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "DURR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-529-2471",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "060.011093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawnee Health Service and Development Corp (Shawnee Health Care, Murphysboro SUD)
• Karen Marie Shubert, RPH
• Colette Ellen Smith, LCSW, CADC
• Robert Mervin Smith, R.PH.
• Todd Smith, MD
• Southern Illinois Hospital Services (St. Joseph Memorial Hospital)
• Southern Illinois Hospital Services (St Joseph Memorial Hospital)
• Southern Illinois Hospital Services (St. Joseph Memorial Hospital)
• Southern Illinois Medical Services, NFP (Medical Arts Clinic)
• Geoffrey Alan Spears, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.