NPIMap

Organization Active NPI

Heartland Family Dental Care of Illinois, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Champaign, IL
National Provider Identifier
1730372012
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
HEARTLAND FAMILY DENTAL CARE OF ILLINOIS, PC
Practice address
314 W Kirby Ave
Champaign, IL 61820-7208
Phone
(217) 366-8371
Fax
(217) 366-8372
NPI assigned
Aug 21, 2007
Organization subpart
Yes
Parent organization
HEARTLAND FAMILY DENTAL CARE OF ILLINOIS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Authorized official

Name
Amy Kroeger
Title
Ins Coord
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

314 W Kirby Ave
Champaign, IL 61820-7208

Mailing address

314 W Kirby Ave
Champaign, IL 61820-7208
Phone (217) 366-8371

Other names 1

  • Champaign Center for Invisible Braces Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Illinois PC75 organizations share this tax ID, including this one
Part of
Dental Professionals of Illinois PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1730372012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W KIRBY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207208",
            "telephone_number": "217-366-8371",
            "fax_number": "217-366-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W KIRBY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207208",
            "telephone_number": "217-366-8371",
            "fax_number": "217-366-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND FAMILY DENTAL CARE OF ILLINOIS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND FAMILY DENTAL CARE OF ILLINOIS, PC",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "KROEGER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "INS COORD",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champaign Center for Invisible Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.