Jack Charles Morkin

Primary specialty

DentistTaxonomy code 122300000X

License

019.034446 Issued in IL

Practice address

119 N Williamsburg Dr
Bloomington, IL 61704-3528

Phone

(309) 663-1326

NPI assigned

Jul 5, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gregory M Randolph DDS & Associates, LTD

  dba Randolph & Associates Family Dentistry

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1104639004
  NPD

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1639857162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 SHEPARD RD",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616434",
            "telephone_number": "309-824-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N WILLIAMSBURG DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043528",
            "telephone_number": "309-663-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORKIN",
        "first_name": "JACK",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-05",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.034446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan-Michaels Family Dentistry, LLC
• Courtney Morgan, DMD
• Elizabeth Denee Morgan, LCSW
• Jacob B Morgan
• David Matthew Morkin, D.D.S.
• Christopher Brian Morrell, MS
• Ashley Morris, MA
• Sara Morrissey
• Matthew Morse, D.C.
• Chloe Morton

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.