Gateway Dental Group of Illinois LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GATEWAY DENTAL GROUP OF ILLINOIS LLC

Practice address

93 Crestmoor
Collinsville, IL 62234

Phone

(314) 518-1088

NPI assigned

Jul 5, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca F Schreiner, DDS

Title

Member

Phone

(314) 518-1088

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530835200000",
    "number": "1639665359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 STONE FALLS CENTER",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "314-518-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 CRESTMOOR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "62234",
            "telephone_number": "314-518-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY DENTAL GROUP OF ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-05",
        "last_updated": "2018-07-06",
        "status": "A",
        "authorized_official_last_name": "SCHREINER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "314-518-1088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Frost, ANP
• Fundamental Behavioral Health
• Sarah Elizabeth Gafford, LCSW
• Shelby F Garvey
• Gateway Anesthesia
• Danica Lee Ann Geaslin Byler, LCPC
• Katelyn Cecelia Genenbacher, DMD
• Laura Gertz, OTR/L
• Shauna Padgett Gholston, M. ED
• Jeantielle M Gonzalez, M.S. CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.