Secure Dental III LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SECURE DENTAL III LLC

Practice address

687 E Linton Ave
Springfield, IL 62703-5902

Phone

(815) 670-2923

NPI assigned

Feb 19, 2015

Last updated

Feb 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Noel Liu, DDS

Title

Owner- Dentist

Phone

(815) 670-2923

Specialties & licenses 1

Addresses

Tax ID family

Secure Dental III LLC2 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.

• Secure Dental III LLC

  dba Secure Dental Lake Station

  • Dental Clinic/Center
  • Lake Station, IN
  • NPI 1235733858
  NPD tax ID

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1720470339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11020 N RUBY CT",
            "city": "DUNLAP",
            "state": "IL",
            "postal_code": "615257523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 E LINTON AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035902",
            "telephone_number": "815-670-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURE DENTAL III LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-19",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "NOEL",
        "authorized_official_title_or_position": "OWNER- DENTIST",
        "authorized_official_telephone_number": "815-670-2923",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Scroggins, MD
• Mary Ann Seagle, APN
• Amanda Seanior, LCPC
• Season for Change Counseling, PLLC
• Angela Brooke Sebree, R.D.
• Kayla Seed
• Kathleen Ann Seelbach, LCPC
• Melissa Seelbach, MSW, LCSW
• Katherine A. Segal, M.S.W.
• Frank Seipp, P.A.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.