Edward L Rick DDS Ms PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

021-000885 Issued in IL

Legal business name

EDWARD L RICK DDS MS PC

Practice address

1808 First Ave
Sterling, IL 61081-1202

Phone

(815) 625-2112

Fax

(815) 625-2143

NPI assigned

Nov 3, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Tracy Gamm

Title

Officer Manager

Phone

(815) 625-2112

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Edward L Rick DDS Ms PC2 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.

• Edward L Rick DDS,Ms,PC

  • Pediatric Dentistry
  • Peoria, IL
  • NPI 1588818736
  NPD tax ID

Locations

Practitioners 1

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

• Edward L Rick, D.D.S., M.S.

  • Pediatric Dentistry
  • Sterling, IL
  • NPI 1639194962
  NPD (past)

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1639322746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 FIRST AVE",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811202",
            "telephone_number": "815-625-2112",
            "fax_number": "815-625-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 FIRST AVE",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811202",
            "telephone_number": "815-625-2112",
            "fax_number": "815-625-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD L RICK DDS MS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "GAMM",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OFFICER MANAGER",
        "authorized_official_telephone_number": "815-625-2112",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021-000885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003466/101354",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney M Duffy, APRN, CNM
• Jesse Duran
• Paula K Durband, LCPC
• Jeffrey Dyke, P.T.
• Kelci Lea Eakle
• Jordan Edwards, B.S.
• Jennifer M Eide, N.P.
• Jason M Ellis
• Elston Psychotherapy LLC
• Christine Elston, DRPH (C), LCSW, MBA

• Pediatric Dentistry in Sterling, IL
• Providers in Sterling, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.