Secure Dental V

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SECURE DENTAL V

Practice address

502 Riverside Dr
East Peoria, IL 61611-2068

Phone

(309) 606-5008

NPI assigned

May 30, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Nazish Jafri, DDS

Title

Owner Dentist

Phone

(815) 708-2762

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783036800000",
    "number": "1629506043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 RIVERSIDE DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112068",
            "telephone_number": "309-606-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 RIVERSIDE DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112068",
            "telephone_number": "309-606-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURE DENTAL V",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A",
        "authorized_official_last_name": "JAFRI",
        "authorized_official_first_name": "NAZISH",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "815-708-2762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri Jean Schafer, APN
• Theresa Schaffer
• Kevin J Schrock, O. T.
• Jessi D Schwind, PT
• Kimberly Marie Scully, PHARMD
• Karen Lynette Sedgwick, CRNA
• Israel P Serrano, BS CADC MISA
• Morgan Marie Shanahan, DMD
• M Annette Sherwood
• Shopko Stores Operating Co. LLC (ShopKo Optical 173)

• Dental Clinic/Center in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.