Active NPI
Tazewell County Health Department -Dental Health Center
- Public Health or Welfare Agency
- North Pekin, IL
National Provider Identifier
1649308230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- E9993-0978-05
- Legal business name
- TAZEWELL COUNTY HEALTH DEPARTMENT -DENTAL HEALTH CENTER
- Practice address
- 135 Radio City Drive
Suite a & B
North Pekin, IL 61554 - Phone
- (309) 382-2229
- Fax
- (309) 382-1155
- NPI assigned
- Mar 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jerry Lee Marshall, DMD
- Title
- Director of Dental Services
- Phone
- (309) 382-2229
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | E9993-0978-05 | IL | Primary |
Addresses
Primary practice location
135 Radio City Drive
Suite a & B
North Pekin, IL 61554
Mailing address
135 Radio City Drive
Suite a & B
North Pekin, IL 61554
Phone (309) 382-2229
National Provider Directory
National Provider Directory- Tax ID family
- County of Tazewell
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Health Educator
- Tremont, IL
- NPI 1174277610
Locations
135 Radio City Dr
Ste A
Pekin, IL 61554
Phone (309) 382-2229
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Normal, IL
- NPI 1821272030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213920000000",
"number": "1649308230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 RADIO CITY DRIVE",
"address_2": "SUITE A & B",
"city": "NORTH PEKIN",
"state": "IL",
"postal_code": "61554",
"telephone_number": "309-382-2229",
"fax_number": "309-382-1155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 RADIO CITY DRIVE",
"address_2": "SUITE A & B",
"city": "NORTH PEKIN",
"state": "IL",
"postal_code": "61554",
"telephone_number": "309-382-2229",
"fax_number": "309-382-1155"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TAZEWELL COUNTY HEALTH DEPARTMENT -DENTAL HEALTH CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-02",
"last_updated": "2008-06-20",
"status": "A",
"authorized_official_last_name": "MARSHALL",
"authorized_official_first_name": "JERRY",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "DIRECTOR OF DENTAL SERVICES",
"authorized_official_telephone_number": "309-382-2229",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "IL",
"license": "E9993-0978-05",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Pekin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.